a —_—_—o=

 

Guan. e Aloes oc.
" Gam4:
oi Bll
OAL onli Rh sey
» tR.

”v ” ”

. Grom: Yank.

" Ah... ..
" Sheear: oe

” Aap Elon: 5.
” Argon Go. ns

N20

lan opt ere een 2)

Mary C.|Gillett ~~

U.S. DEPCSITDRY
JEG REEL:
NAME

"UB al gs
hoi z

 

     
      
     

 

.
!

’

FE
* . .

en ot ih

 

    

” ”

nw Sob: Volar.

OPRer .
Comer of Milry Histon United States Amy.

os EL

  

 

 

 
: I a

=

Ey
1

eh

 

 
GT

AR MY MED. DEPT. 1775- 81% |

THE ARMY MEDICAL DEPARTMENT [lc |
1775-1818
ARMY HISTORICAL SERIES

Maurice Matloff, General Editor

ADVISORY COMMITTEE
(as of February 1979)

Otis A. Singletary (Chairman)
University of Kentucky

Brig. Gen. Robert Arter
Command and General Staff College

Harry L. Coles
Ohio State University

Robert H. Ferrell
Indiana University

Cyrus H. Fraker
Office of The Adjutant General

William H. Goetzmann
University of Texas

Col. Thomas E. Griess
U.S. Military Academy

Maj. Gen. Robert C. Hixon
Training and Doctrine Command

Sara D. Jackson, National Historical
Publications and Records Commission

Maj. Gen. Enrique Mendez, Jr.
Office of The Surgeon General

James E. O'Neill, Deputy Archivist
of the United States

Benjamin Quarles
Morgan State College

Brig. Gen. Alfred L. Sanderson
Army War College

Russell F. Weigley
Temple University

U.S. ARMY CENTER OF MILITARY HISTORY
Brig. Gen. James L. Collins, Jr., Chief of Military History

Maurice Matloft
Chief Historian

Col. James W. Dunn
Chief, Histories Division

Col. William F. Strobridge
Chief, Historical Services Division

Col. Earl L. Ziebell
Chief, Editorial/ Cartographic Division

James E. McSherry
Editor in Chief
The Army Medical Department
1775-1818

Mary C. Gillett

 

CENTER OF MILITARY HISTORY
UNITED STATES ARMY
WASHINGTON, D.C.

 

 
 

537-00

The Author: Dr. Mary C. Gillett studied at
Wellesley College and received her B.A.,
M.A. and Ph.D. degrees from The American
University.

Library of Congress Cataloging in Publication Data

Gillett, M. C.
The Army Medical Department, 1775-1818.

(United States Army historical series)

Bibliography: p.

Includes index.

1. United States. Army Medical Dept.—History. 2. Medicine,
Military—United States—History. 3. United States—History—
Revolution—1775-1783—Medical and sanitary affairs. 4. United States—
History—War of 1812—Medical and sanitary affairs. I. Title.

II. Series. [DNLM: 1. Military medicine—History—United States.
UH223 G479a]
UH223.G54 355.3'45'0973 80-12502

First printing 1981

 

For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402
Contents

Foreword
Preface

The State of the Art
Medicine 1/ Surgery 14/ Medical Education and Experience 18

Evolution of the Continental Army Medical Department
Creation of the Hospital Department: Church as Director General
22/ Morgan as Director General, 1775 to 1777 29/ New Ar-
rangements for the Hospital Department 35/ Shippen’s Contro-
versial Administration 38/ The Hospital Department Under
Cochran 44

From Siege to Retreat, 1775 to May 1777
The Boston Area, 1775 to 1776 50/ The Northern Department
57/ New York and New Jersey, 1776 to 1777 65/ Hospitals in
New York State and New England After the Evacuation of New
York City 72

Year of Despair and Hope, June 1777 to June 1778
The Middle Department 77/ The Northern Department 92/
The Eastern Department 97

From Defeat to Victory, June 1778 to 1783
North of the Potomac: Before the Victory at Yorktown 99/
South of the Potomac: Before the Victory at Yorktown 115/ After
the Victory at Yorktown 123

Between Wars, 1783 to June 1812
Continental Army Patients Remaining in Hospitals 133/ Cam-
paigns Against the Indians 133/ Forts and Their Garrisons 138/
Wilkinson in the Louisiana Territory, 1809 140/ Management of
Supplies 144

Administration of Medical Support, June 1812 to January 1815
Opening Months of the War of 1812 148/ Work of the Medical
Department 149

UH2RSB
25

PerBe

Xi

22

50

77

99

129

148
vi

10

AoE ITQmmogogaOow >

O00 php WN

CONTENTS

Early Campaigns in the North, 1812 to 1813
Season of 1812 157/ Season of 1813 164

Defeat and Final Victory, 1814 to 1815
Campaign in the North 172/ Campaign in the South 178

The Lessons of War, 1815 to 1818
Indecision and Decision, March 1815 to April 1818 186/ The
State of the Art 190

Appendixes

Some Influential Doctors in the Continental Hospital Department,
1775 to 1783

Law of 27 July 1775

Law of 17 July 1776

Law of 7-8 April 1777

Law of 6 February 1778

Law of 30 September 1780

Hospitals Serving Washington’s Army

An Act to Regulate the Medical Establishment, 2 March 1799

Legislation Concerning the U.S. Army Medical Department

Duties of Members of the Medical Department, 1814

Legislation Affecting the Army Medical Department, March 1815 to
April 1818

Notes
Bibliography
Index

Maps

Boston Area, 1775-1776

The Northern Department, 1775-1777
Continental Army Hospital Locations, 1776-1777
Continental Army Hospital Locations, June 1777-June 1778
Northern and Eastern Departments, 1777-1778
Hospital Locations, 1778-1783

Sullivan Expedition, 1779

The Southern Theater, 1778-1783

Northwest Territory, 1783-1811

War in the North, 1812-1814

Niagara Frontier, 1812-1814

The Southern Frontier, 1812-1814

157

172

186

199
200
200
201
204
205
210
211
213
213

214

217
269
289

50
58
68
78
93
100
107
116
132
158
168
179
Contents

Illustrations
Hermann Boerhaave 1 Washington Hall 88
William Cullen 2 Brethren’s House at Lititz 89
Sir John Pringle 2 Brothers’ House at Ephrata 90
Richard Brocklesby 4 James Thacher 94
Gerhard van Swieten 5 Philip Turner 98
John Hunter 5 Hospital Hut Designed by
Hales’s Sketches of Plans for Dr. James Tilton 104
Ventilators 9 Robinson’s House 105
John Jones 10 David Oliphant 117
Contrast Between Vaccina- Thomas Tudor Tucker 118
tion and Inoculation 12 William Read 119
Petit’s Screw Tourniquet 16 James McClurg 121
Act Creating Hospital College of William and Mary:
Department 24 Wren Building 122
Benjamin Chegrch 26 Richard Allison 134
John Morgan 29 Fort Washington 135
Surgeon’s Field Case 30 Fort Defiance 136
William Shippen, Ir. 24 “Estimate of Medicine, Hos-
Beajariin Rush 36 pital Stores, etc. for Eighty
Join Cochran 44 Men [for] One Year” 145
John Warren 51 . 50
Charles McKnight 51 Jame S Tagon . 3
Return Signed by Charles Benjamin Waterhouse 5
McKnight 54 William Beaumont 160
g
Return of the Sick of the Joseph . Lovell 161
Hospital at Fort George 61 Fort Niagara 166
James McHenry 62 “Soldiers Who Died at the
Brethren’s House at Genl. Hospital Greenbush
Bethlehem 71 Together With Their Ef-
William Eustis 73 fects” 176
Bodo Otto 80 New Orleans in 1815 182
Valley Forge Hospital Hut ~~ 85 Three Oaks Mansion 183
Schoolhouse Used as Hospital Statement on Hospital Sup-
at Valley Forge 86 plies Sent From New York 189

vii
viii

9]

NO CQ on

CONTENTS

Tables

Authority Within the Continental Army’s Medical Services, 1775-83 23
Hospital Department Units in the Boston Area With the Status of

Patients During Week Preceding 2 December 1775 52
Hospital Department Units in the Boston Area With the Status of

Patients During Week Preceding 16 December 1775 53
Mortality, 16 December 1775-30 March 1776 53
Patients in Hospital Department Units, New York City Area, April-

June 1776 66
Middle Department Hospital Patients, 24 November 1777 80

Organization of Medical Support of the Regular Army, 1784-1813 130

Pay and Allowances for the Staff of the Medical Department, May 1813 150

Admissions and Deaths at the Burlington General Hospital, January
1814-April 1815 173

A
ty

Foreword

This is the first volume of a history of the U.S. Army Medical
Department from the start of the American Revolution to World
War I. This book deals with the period when the Medical De-
partment existed only as a wartime expedient and concludes with
the passage in April 1818 of the law that finally established the
department on a permanent basis. Future volumes will describe
all aspects of the medical care of soldiers scattered in small
units over the rapidly growing nation and the challenges posed
by war in the nineteenth and twentieth centuries. The discipline
that governed Army surgeons and their patients enabled them to
control treatment and record its results with a precision and
regularity impossible in civilian medicine. Thus Army surgeons
and the Medical Department played a large role in the progress
of medical science, a role not always recognized by the profes-
sion, by the scholarly community, or by the public at large.

This new history of the Army Medical Department tells the
beginning of that story. It is a significant and long needed con-
tribution to the study of military medicine.

JAMES L. COLLINS, JR.
Brigadier General, USA
Chief of Military History
Washington, D.C.
2 August 1979
 

 

a

”

Preface

This volume was originally planned as a Bicentennial study
of the Medical Department of the Continental Army. Since existing
histories of the Army Medical Department were either out of
date or based upon antiquated studies, however, the project was
expanded to make the present volume the first of a series on
Army medicine.

Only the operations of the department are treated here. The
activities of surgeons not directly under its authority, such as
militia surgeons and, for a short period, regimental surgeons,
have not been explored. Coverage of military operations has been
limited to that necessary for understanding the demands on the
department. And the author has resisted the temptation to con-
demn the medical men of the period for their unscientific and
largely ineffective medicine; they deserve to be judged by the
standards of their contemporaries.

Few official records from the period before 1814 exist. People
of the era lacked our own devotion to record keeping, and much
of their meager accumulation was destroyed by fire in 1800 or
lost in 1814 when the British occupied Washington. Most of the
documents that survived these two disasters are now held by the
National Archives and Records Service in Washington, D.C. The
scarcity of official records has made it particularly necessary for
the author to explore such unofficial sources as the informal
records, diaries, memoirs, and letters of those who were familiar
with the work of the Medical Department. This search covered
the National Archives, the Library of Congress, the National
Library of Medicine, and the Historical Society of Pennsylvania.
Many other individuals and institutions have also provided val-
uable assistance in the form of microfilms or copies of documents,
suggestions for further contacts or sources, expert opinions con-
cerning problems encountered as work progressed, or reviews
of the manuscript in its entirety or in part.

It is impossible to thank by name all those who have in one
way or another contributed to this volume. The author is particu-
larly indebted to Mrs. Dorothy Hanks and the staff of the History
xii

PREFACE

of Medicine Division of the National Library of Medicine, in-
cluding Ms. Lucinda Keister of the Arts Section; Dr. George
Chalou and Dr. Elaine C. Everly of the Old Military Records
section of the National Archives and Records Service; Mr. Peter
J. Parker of the Historical Society of Pennsylvania and Mr. Gary
Christopher, formerly of the Historical Society of Pennsylvania;
Dr. Richard Blanco of the State University College at Brockport,
N.Y.; and Dr. John Duffy of the University of Maryland, who
reviewed the first five chapters of the volume. Others who pro-
vided especially valuable help were Dr. Whitfield J. Bell, Jr., of the
American Philosophical Society Library in Philadelphia; Mr.
Francis James Dallett, Archivist of the University of Pennsylvania;
Mr. James W. Coleman, Jr., and Ms. Alberta L. Appleby of the
Morristown National Historical Park; Mr. William R. Cullison,
Curator of Prints and Drawings, Tulane University Library; Miss
Margaret Cook of the Library of the College of William and
Mary in Virginia; Mr. Vernon H. Nelson, Archivist of the Archives
of the Moravian Church in Bethlehem, Pa.; Col. J. E. Henderson,
VC, USA, Curator of the Medical Museum of the Armed Forces
Institute of Pathology; the staff of the Graphic Arts Branch of
Fort Detrick, Md.; and Miss Elizabeth Thomson, who generously
shared the fruits of her research on the Doctors Bond.

The author is indebted to Col. Robert J. T. Joy, MC, USA,
formerly Director of the Walter Reed Army Institute of Research
and now Chairman of the Department of Military Medicine and
History at the Uniformed Services University of the Health
Sciences, who reviewed the entire manuscript and made many val-
uable suggestions, including several concerning the true nature
of the diseases so unscientifically described by physicians 200
years ago. Dr. Erna Risch, formerly Chief Historian of the U.S.
Army Materiel ‘Command, also reviewed the entire manuscript;
her comments have contributed significantly to its accuracy and
coherence.

Members of the staff of the U.S. Army Center of Military His-
tory have also played important roles in the preparation of this
volume. Dr. Robert W. Coakley, Deputy Chief Historian, re-
viewed the entire manuscript and made many helpful suggestions.
The maps were prepared under the direction of Mr. Arthur S.
Hardyman, Chief of the Cartographic Branch. The author also
wishes to acknowledge the support of the successive directors of
The Historical Unit of the U.S. Army Medical Department, part
of which became the Medical History Branch of the Center of
Preface

Military History. The author is especially grateful to Mrs. Mary
D. Nelson of the Editorial Branch, who edited the manuscript
for publication; the author’s historian colleagues, Ms. Pauline B.
Vivette and Mr. George W. Garand, who gave freely of their time
and expertise; and the late Dr. Rose C. Engelman, Chief Historian
of the former Historical Unit, under whose supervision the book
was written.

The responsibility for all errors remains entirely that of the
author.

Mary C. GILLETT

Washington, D.C.
2 August 1979

Xiii
1

The State of the Art

The colonial physicians who formed the
American Army’s Medical Department in
1775 were all civilian practitioners, many
without any military experience. A small
percentage had earned M.D. degrees, but
most were either apprentice or self-trained,
and few made any attempt to specialize in
the manner customary in Europe, where a
choice was usually made among medicine,
surgery, and pharmacy. During the second
half of the eighteenth century, however,
American doctors were growing in stature
at home and abroad. Although more of
them were receiving a formal medical edu-
cation, usually in Europe, they were still
limited by the general lack of scientific data
and by their profession’s predilection for
reasoning rather than research as a way of
discovering better forms of treatment for
their patients. The traditional humoral ex-
planation for disease was by this time
losing ground to several new and conflicting
systems, where fact took second place to
theory, in an all-out attempt to reveal one
or two basic causes for all disease. Disagree-
ments over therapy gave added intensity to
the feuds and controversies which character-
ized eighteenth century practice, in general,
and American medicine, which was not re-
strained by European guild traditions, in
particular. Furthermore, the effort to develop
a fundamental theory deemphasized the im-
portance of the diagnosis of specific diseases.
Treatment continued to consist largely of
bleeding, purging, and blistering, regardless
of the symptoms, since surgery alone was
based to any significant degree upon ex-
perience as a guide in preference to theory.’

MEDICINE

The system prevailing in the colonies in the
years immediately preceding the American
Revolution, that of the great Dutch phy-
sician and teacher Hermann Boerhaave, ex-
plained disease in terms of chemical and
physical qualities, such as acidity and alka-
linity, or tension and relaxation, instead of
the blood, phlegm, yellow bile, and black
bile of the traditional humors, and urged
that nature be permitted to aid in any cure.
The Boerhaavian system was increasingly
challenged in the second half of the century
by that of William Cullen, the Scottish phy-
sician and teacher so much admired by

 

HERMANN BOERHAAVE. (Courtesy of National
Library of Medicine.)
2 THE ARMY MEDICAL DEPARTMENT,

 

WILLIAM CULLEN. (Courtesy of National Li-
brary of Medicine.)

Americans studying under him at the Uni-
versity of Edinburgh, many of whom would
later be leaders in the Continental Army’s
Hospital Department. Cullen believed that
either an excess or an insufficiency of nerv-
ous tension underlaid all disease. Too much
tension was often characterized by a fever,
to be treated by a depleting regimen includ-
ing bleeding, a restricted diet, purging, and
rest and sedation. A cold or chill, on the
other hand, indicated too much relaxation
and called for restorative measures. In time,
Cullen became so influential that Benjamin
Rush, just gaining prominence in American
medicine during the Revolution, was able
to write his former teacher that the Ameri-
can edition of his work “was read with
peculiar attention by the physicians and
surgeons of our army, and in a few years
regulated in many things the practice in our
hospitals.” *

Despite his doctrine that disordered nerv-
ous tension was the cause of all disease,
Cullen encouraged the study and classifica-
tion of specific diseases. Rush, however,

1775-1818

eventually modified Cullen’s doctrines, which
he had originally so much admired, and dis-
couraged the study of separate disease enti-
ties by blaming all disease on excessive
tension which caused disturbance in the
blood vessels. By 1793, he was openly con-
tending that there was but one single disease
in existence. The method of treatment upon
which Rush insisted with increasing inflexi-
bility called for a low diet, vigorous purges
with calomel and jalap, and bleeding until
the patient fainted. Rush apparently did not
hesitate to remove a quart of blood at a
time, or, should unfavorable symptoms con-
tinue, to repeat such a bleeding two or three
times within a two- to three-day period, it
being permissible in his opinion to drain as
much as four-fifths of the body’s total blood
supply. In time, Rush’s system and treatment
became, in the words of a noted medical
historian and physician, “the most popular
and also the most dangerous ‘system’ in
America.” *

 

SIR JOHN PRINGLE. (Courtesy of Library of
Congress.)
Ch. 1]

Theorists of the eighteenth century did
not generally include in their systems an ex-
planation for the outbreak of certain forms
of disease among many people in one area
within a short period of time. According to
his background, training, and experience,
therefore, a physician might blame mass out-
breaks of disease on climate and season,
unhealthy elements in the air, contagion,
possibly caused by ‘“animalcules,” or God’s
determination to punish sinful man. There
were many discussions of possible sources
of disease carried by the air. Rush strongly
believed in the danger of bad odors, or
miasmas, and Sir John Pringle, a noted
British Army surgeon and a Physician Gen-
eral in the British Army from 1745 to 1758,
much respected by the many Americans
who knew him in their student days, wrote
that putrefaction was the greatest cause of
fatal illness in armies. He listed corrupted
marsh water, human excrement remaining
exposed in the hot weather, crowded mili-
tary hospitals, and straw used for bedding
rotting in tents as the four principal sources
for putrid air. Although he recognized cold
as a predisposing factor in disease, Pringle
noted that heat, too, was often a cause of
sickness, especially when wet clothes and
beds or a very humid atmosphere tended to
interfere with normal perspiration, “relax-
ing the fibers and disposing . . . to putre-
faction.” He found it “not surprizing [sic]
that the dysentery and bilious fever, both
putrid diseases, should ensue.” The theory
of the atmosphere as a cause of many
types of fevers was still maintained as late
as 1812. David Hosack, a respected Ameri-
can physician, pointed out at that time, how-
ever, that disease might also be spread by
direct physical contact, as in syphilis and
scabies, or through the purest air, as with
smallpox. Many authorities at that time also
blamed sudden changes in the weather for
causing outbreaks of disease.*

The average eighteenth century physician
had little in the way of either equipment or

State of the Art 3

understanding to aid him in distinguishing
one specific disease from another. The con-
cept of a standard body temperature had
only been suggested, the body’s heat-regu-
lating mechanism was not understood, and
Fahrenheit’s recently developed mercury
thermometer was not commonly used by
physicians. The stethoscope was not in-
vented until 1814, and although a “pulse
watch” had been developed in 1707, it also
was largely ignored by physicians, who
preferred describing the pulse to counting
it. The use of percussion to aid in diagnosis,
however, was beginning to become more
widely understood because of the work of
the Viennese physician Leopold Auenbrug-
ger. The reasoning underlying some eight-
eenth century diagnoses, however, may seem
strange to us today. When a fever described
as yellow fever responded to quinine, for
example, rather than concluding that the
fever was in reality malaria, the eighteenth
century physician assumed that quinine must
be effective against yellow fever. Since all
fevers were regarded as stemming from the
same physical unbalance, such a conclusion
was logical. Rashes were not regarded as
particularly significant in diagnosis, and dif-
fering symptoms appearing in patients be-
lieved to have the same disease might be
brushed off as indicative merely of the
conditions under which the illness was con-
tracted.’

In the eighteenth century and, as far as
the U.S. Army was concerned, until World
War I, disease invariably caused more
deaths than wounds. It has been estimated
that, during the American Revolution, 90
percent of the deaths occurring among the
inexperienced, poorly clothed, poorly fed
soldiers of the Continental Army, most of
them country boys without previous ex-
posure to communicable diseases, and 84
percent of those among the seasoned, disci-
plined British regulars were from disease.
Under the circumstances, however, it is
difficult today to determine from the diag-
4 THE ARMY MEDICAL DEPARTMENT,

noses and descriptions of eighteenth century
physicians what specific diseases were most
common in the army of that period. Respira-
tory illnesses were most often seen in cold
weather and dysenterylike conditions in hot
weather, while fevers were always a threat.
Venereal disease was common, and smallpox
could wreak havoc in the ranks of American
armies. Scurvy was a danger on land as on
sea, and scabies, otherwise known as the
Itch, was a more than ordinary nuisance for
military forces. Other diseases, such as
diphtheria and scarlet fever, were less com-
mon in eighteenth century armies despite
their occasionally devastating effects upon
the civilian population.®

Whatever the eighteenth century diag-
noses were, eighteenth century fevers were
often in fact malaria, widespread in the
colonies and endemic from New England
southward. Yellow fever, despite its fearful
reputation, was endemic only in the deep
South, although rare outbreaks occurred
during the summer in a few ports north of
Charleston, South Carolina. The incidence
of malaria was rising during the Revolution,
especially in the South with its long hot sum-
mers and undrained swamps, affecting with
particular severity, for example, not only
Cornwallis’s men but also New Englanders
participating in the fighting around York-
town. Although mosquitoes were rarely
suspected as carriers of disease, eighteenth
century physicians were aware of the re-
lationship of fevers to swamps and un-
drained areas.”

While “intermittent” and ‘“‘remittent”
fevers were probably malaria, those called
putrid, malignant, jail, or hospital may have
been either typhus or typhoid. Authorities
do not agree on the extent to which late
eighteenth century physicians could differ-
entiate between these two diseases.®

An examination of the writings of the
period shows, however, that when British
military physician and author Richard
Brocklesby made his diagnoses, he did not

 

1775-1818

RICHARD BROCKLESBY. (Courtesy of National
Library of Medicine.) /

take into consideration the petechiae which
modern physicians believe to be the key to -
a definite differentiation between the two
diseases in the absence of laboratory tests.
British surgeon Donald Monro, furthermore,

%&

believed that the symptoms manifested by ag™"

malignant fever depended upon the condi-
tions prevailing at the time the disease was
contracted, and the prominent Austrian mili-
tary surgeon Gerhard van Swieten con-
sidered the appearance of a rash to be an
indication of a favorable outcome rather
than one of the nature of the disease. A
modern authority on the epidemic diseases
of pre-Revolutionary America also points
out that “Not only was typhus rarely found
in the colonial period but even after the
Revolution the United States remained rela-
tively free of the infection.” He ranks typhus
in importance after malaria, dysentery, and
typhoid.®

Eighteenth century soldiers “often ex-
posed to the putrid Steams of dead Horses,
of the Privies, and of other corrupted

hk
 

‘GERHARD VAN SWIETEN. (Courtesy of Nation-
al Library of Medicine.)

“ Animal or Vegetable substances, after their
juices had been highly exalted by the Heat
of Summer” 1 sometimes found themselves
afflicted with “A flux of the belly, attended
with violent gripings, of very painful strain-
ings for iy 11 This was blamed on “ob-
structed Perspiration,” 2 or on “bile grown
acrid by the great heats and the fatigue of
war” when “the soldier, when hot, suddenly
exposes himself to cold air, or sleeps in his
cloaths [sic], soaked with rain” as well
as on stagnant water and tainted food.
Van Swieten, whose work was influential in
America, believed that dysentery could be
spread through an entire army by the
breath of those afflicted with the disease
and that ortinry diarrhea could degenerate
into dysentery if not promptly treated with
a mild purge followed by a dose of opium.
In the eighteenth century, however, even
dysentery itself often remained untreated.
The soldier unlucky enough to be so af-
flicted might, indeed, prefer neglect to the

State of the Art * 5

very generous doses of purgatives and
emetics required by eighteenth century doc-
trine, or to the blister which would adorn
his abdomen should the physician determine
that this portion of his anatomy was too
tense. It was only after he had survived these
remedies that the patient could hope for a
dose of opium, which might at least tem-
porarily relieve his agony even if his disease
had bees misdiagnosed, a distinct possibility,
and was actually typhoid or typhus.'?
Venereal disease was another ever-present
threat to the eighteenth century army but
one not always reported because of the
punishment often administered to its victims.
Some modern historians believe that eight-
eenth century physicians could distinguish
between gonorrhea and syphilis, but exam-
ination of a number of publications of the
time suggests that the distinction was par-
tial at best. The British John Hunter, one
of the century’s finest surgeons and anat-
omists, stated that the two were but “dif-
ferent forms of the same disease,” gonorrhea

 

JouN HUNTER. (Courtesy of National Library
of Medicine.)
6 THE ARMY MEDICAL DEPARTMENT,

being the form in which the urethra alone
was affected and chancre a nonsecreting
version of the same disease. Hunter could
state this confidently even while he noted
with surprise that mercury, which cured
chancre, only made gonorrhea worse.
Brocklesby, too, considered gonorrhea but
one symptom of “lues venera,” as did van
Swieten and at least one physician as late
as 1815.18

Although it may not have been fatal,
scabies brought more patients to British
Army hospitals during the Seven Years’
War than any other condition, according to
British Army surgeon Donald Monro. Its
cause was known to be “Little Insects
Lodged in the Skin, which Many Authors
Affirm They Have Seen in the Pustules by
the Help of a Microscope.” 1 The Itch was
very common in colonial America, Benja-
min Franklin’s mother-in-law having adver-
tised a remedy for it in 1731. The condition
usually appeared first between the fingers in
the form of a “pustule, or two, full of a sort
of clear water, which itch extremely: where
these pustules are broke by scratching, the
water that issues out communicates the dis-
order to the neighboring parts . . . in its
progress the pustules augment both in num-
ber and size, and when opened by scratching
a disgusting crust is formed.” The favorite
remedy for the Itch seems to have been
sulfur, a remedy still in use today, applied
in either an ointment or a soft soap.”

Among the respiratory ailments often
afflicting armies in the eighteenth century
were pneumonia, often called peripneu-
monia, and pleurisy. Van Swieten suggested
treating the former, as soon as diagnosed,
by a “large bleeding in the arm” but also
urged that the air be kept moist and the
patient encouraged to bring up the secretions
from his lungs. If the progress of the disease
weakened the patient, however, this author-
ity recommended that bleeding, purging,
and sweating be avoided. The soldier un-
fortunate enough to be afflicted with so

1775-1818

severe a pleurisy that the pain interfered
with his breathing would be treated not
only to bleeding but also to blistering, clys-
tering, and, to encourage the pus to drain
outward and thus avoid the formation of
an abscess, plastering. If the patient could
not sleep, he might be dosed with a syrup
of white poppies. To soothe his cough, his
medicine would be administered while
lukewarm, and wine, salt, and acid foods
would be denied him.18

Specific types of therapy for specific
diseases were understandably not too com-
mon in the eighteenth century and certain
remedies were used for almost all diseased
conditions. Bleeding was popular, the
amount and frequency varying with the
individual physician and the system he fol-
lowed. A moderate bleeding was considered
to be one taking 8 to 12 ounces at a time,
a heavy one 16 to 20 ounces. Cleansing the
digestive tract was another generalized
remedy followed with or without much
caution, using such purgatives as rhubarb,
manna with tincture of senna, or Rush’s
favorites, jalap and calomel, emetics such
as ipecac and antimony, and enemas of
varying formulation.!?

The following order for medicines and
hospital stores for Fort Meigs placed by
Brig. Gen. William Henry Harrison during
the War of 1812 suggests that the same
kinds of medicines remained popular for
many decades:

Peruvian bark (in powder) 50 1b.
Opium 10 lb.
Camphor 10 1b.
Calomel S bb,
Corrosive sublimate 2b.
Tartar emetic 2 1b.
Gambage 2 1b.
Jalap 10 Ib.
Ipecuanto 17 1b.
Rhubarb (in powder) 10 1b.
Kino 15 Ib.
Colombo (in powder) 20 1b.
Nitre crude 20 Ib.
Nitre sweet spirits 40 1b.
hl

Ch. 1]

Glaubers salts 50 1b.

Prepared chalk 20 Ib.
Castor oil 12 gal.
Olive oil 5 gal.
Gum arabic 20 1b.
Allume 5 Ib.
Acquous 20 1b.
Adhesive plaster 20 Ib.
Barley 2 bbl.
Chocolate 300 Ib.
Tapioca 50 Ib.
Blistering ointment 20 1b.
Beeswax 20 1b.
Muriated acid 4 1b.
Sulphuric acid 4 1b.
Nitric acid 4 Ib.
Vials 5S gross
Instruments
Amputation 3 sets
Trepanning 3 sets
Pocket 3 sets
Cases scalpels (No. 6) hw
Lancets 3 doz.
Splints 12 sets
Sponge 7 1b.
Muslin 1,000 yd.
Wine 200 gal.
Brandy or rum 100 gal.
Vinegar 200 gal.
Molasses 200 gal.
Coffee 300 1b.
Hyson tea 50 1b.
Rice 5 bbl
Sugar 5 bbl.
Sago 50 1b.
Source: William Henry Harrison to Secretary of War,

30 Jun 1813, Harrison, Messages, 2: 486

Among the newer ideas in medicine was
the belief in the general wholesomeness of
fresh air. Benjamin Franklin was among
its most ardent supporters. Allied with this
was the newly popular “cooling regimen in
fevers,” involving not only cool fresh air
but also the bathing of fever patients in
cold water. Yet another generalized remedy
of recent origin was mercury, used earlier
against venereal disease and as a purgative,

but now also used as an alterative to °

treat many diseases, often in the form of

State of the Art 7

calomel or the reputedly better tasting but
more nauseating corrosive sublimate. Its
new popularity was, an American physician
boasted, “in its origin exclusively American,
and . . . to our colonial physicians the world
is indebted for one of the greatest improve-
ments ever made in practical medicine.”
Mercury was increasingly prescribed after
1750 for diseases classified as inflammatory,
particularly pleurisy, pneumonia, and rheu-
matism, but it was also eventually used for
typhus, yellow fever, dysentery, smallpox,
tuberculosis, dropsy, hydrocephalus, and
diseases of the liver, with Rush in the fore-
front of its many enthusiasts.?* Another
noted American physician of the period,
David Ramsay, explained the working of
mercury by claiming that it set up an arti-
ficial illness, ‘‘transferring diseases of the
head, of the eyes, and of the bowels to the
mouth, where they are less dangerous and
more manageable,” 2! in line with the prin-
ciple put forward by John Hunter that “no
two fevers can exist in the same constitution,
nor two local diseases in the same part
at the same time.” 22 Others accounted for
the action of mercury by its weight, saying
that mercury compounds expelled “morbid
matter” from the digestive system and
cleared out the glands, particularly the sali-
varies, and the blood vessels, promoting
better circulation and eliminating disease.??

It is not likely that there were any
physicians at that time unaware of the un-
pleasant side effects of mercury, since even
laymen could recognize them and physicians
were at times forced to order smaller than
usual doses lest the patient realize what he
was receiving and refuse to take it. Diarrhea,
bleeding gums, nosebleeds, and loosening of
the teeth were among the consequences the
American physician John Warren described
as “frequently troublesome and at times
alarming.” 2*

A far more pleasant eighteenth century
remedy was wine, the use of which was most
prevalent from 1700 to 1900. It was used
8 THE ARMY MEDICAL DEPARTMENT,

as a stimulant to the appetite, a sedative, a
diurctic, and merely as a nutritious addition
to the diet. Particular wines might be pre-
scribed to relieve specific symptoms, with
or without the addition of spices, fruit juices,
and grated rinds. An astringent red wine was
recommended for diarrhea, port for anemia
and acute fevers, claret and burgundy for
anorexia, and champagne for nausea and
throat ailments. White wines were thought
to make fine diuretics, while fortified wines
in general were prescribed for convales-
cents.?®

Opium, often in the form of laudanum,
came to be used frequeritly in the late eight-
eenth century, to the point where it was
“gencrally found in most decent families
for domestic prescription.” Samuel Bard,
a noted colonial physician, had studied the
effects of opium on the human body and
recorded that it acted on the nervous sys-
tem rather than the blood, slowed bowel
action, suppressed urine, lessened pain and
spasms, and brought sleep.?¢ -

Quite aside from the state of the art of
diagnosis and treatment, the hospital in
which he found himself played an important
role in the fate of the sick or wounded
soldier and, indeed, in the long run, in the
fate of the army itself. The wars of the
eighteenth century and particularly the Seven
Years’ War between France and Britain,
therefore, inspired much writing by experi-
enced army surgeons of both nations on
the military hospital and its management.
Considerable emphasis was placed upon the
need for planning ahead for the numbar and
types of hospitals required. The Frenchman
Hugues Ravaton, considering this problem
in 1768, wrote that one could assume that
three of every 100 soldiers would be ill at
the beginning of a European campaign.
Halfway through the campaign, a probable
five or six of 100 would be out of combat
because of disease, and by the. end of a
campaign, if the victims of venereal disease
and nonbattle injuries were counted, ten to

1775-1818

twelve of 100 would be unable to fight be-
cause of illness. A day’s battle would pro-
duce, he estimated, ten wounded per 100
combatants, but this percentage would
drop as the number involved approached
100,000.27

Armed with this type of information, an
army medical department could predict the
number of general and regimental hospitals
needed for the predictable number of pa-
tients. The general hospital remained in
one place and was staffed by the physicians
and surgeons of the medical department, as
was the flying hospital in the British Army,
which accompanied an army as it moved
about. The regimental hospital was directed
by the regiment's surgeon and mates, and
its patients could be sent back to the gen-
eral hospital, as were those of the flying
hospital when it had to move. Considerable
controversy raged at times between the
proponents of the general hospital and those
of the small regimental one. The infection
and bad air of the general hospital caused
many authorities to favor the smaller fa-
cility or at least to urge that the general
hospital be divided among several locations.
Locating hospitals so that the sick or
wounded soldier would have to be moved
for any great distance was also considered
inadvisable.?"

In the management of the individual hos-
pital, eighteenth century military experts
emphasized the necessity for good order,
good air, and careful sanitation, as well as
for the proper staff, which should include
physicians, surgeons, mates who functioned
as assistants to either physicians or surgeons,
apothecaries, nurses, and a purveyor to
handle supplies. Although the principle was
not always observed in the British Army,
Monro in particular emphasized that the
direction and the purveying for a hospital
should never be assigned to the same man,
“as the Temptation of Accumulating Wealth
has at all Times, and in all Services, Given
Rise to the Grossest Abuses,” a truth of

-

A
¥
\
Ey

 

® Fir Ly

k= N
a

Em

X

  

HALES'S SKETCHES OF PLANS FOR VENTILATORS. (Courtesy of National Library of Medicine.)

which the organizers of the Continental
Army’s first medical department should have
been more conscious. Also required was a
guard to keep order and to see that patients
obeyed the orders of the physicians, particu-
larly in regard to such matters as drinking
and receiving visitors. An inspector general
should be assigned to visit each hospital
at least once a week to ensure proper care
and discipline.??

Good air supply could be achieved by
using large rooms with high ceilings, by
avoiding overcrowding, and even by using
the newly developed, manually operated
Hales ventilators, by means of which “foul
air may be removed from hospitals,” by
burning frankincense, juniper wood and
berries, or sulfur, or by using the steam
from vinegar. Good sanitation also required
proper care of privies, frequent scrubbing
of walls, floors, and bed frames, and
thorough airing or even impregnating woolen
clothing and blankets with the fumes of
muriatic or nitric acid or of burning sulfur.
Straw rather than feathers was preferred
for filling mattresses because of the difficulty
of cleaning feather beds.3¢

Contagion could also be prevented by
putting surgical and venereal disease pa-

tients into a separate room Or even a
separate hospital, away from those ill with
fevers and dysentery, who should have
their own well-aired wards and, hopefully,
their own nearby privies. As much as pos-
sible, those with similar diseases should be
kept together. Each patient should, in any
case, be bathed and dressed in clean cloth-
ing before being admitted to a ward, and
his hands and face washed routinely every
morning. The physician visiting patients
should wear clothing especially set aside for
the purpose plus a “waxed linen coat to
wear above them in going round to wards”
and should never visit a hospital with an
empty stomach if he wished to avoid becom-
ing ill himself. When visiting patients with
infectious diseases, furthermore, the physi-
cian should take tincture of bark before
entering the room, put rolls of lint impreg-
nated with camphorated spirits in his nose,
place a bowl of camphorated vinegar near
the patient he was visiting, and hold his
breath while physically examining the pa-
tient, standing back from the bed when it
was necessary to ask a question. Peter Mid-
dleton, another prominent American phy-
sician, suggested that the doctor in such
instances might even hold tobacco in his
10 THE ARMY MEDICAL DEPARTMENT,

mouth to guarantee that he did not swallow
saliva which might have become infected
while he was in the sickroom.?3!

Preventive medicine played an extremely
important role not only within the military
hospital but also throughout the entire
eighteenth century army. Increasing atten-
tion was now also being paid to the idea
of being sure that the soldier was reasonably
healthy before he entered the service, es-
pecially since it was recognized that the
stress of entering the army made the new
recruit particularly susceptible to disease. It
had long been realized that, since disease
was caused by ‘changes in the sensible
qualities of the air, excesses in dirt, and
irregularities in exercise,” effective preven-
tion of disease also required the close reg-
ulating of the soldier’s everyday life and
environment once he had officially joined the
army. The choice of a campsite was of the
greatest importance, with damp areas being
particularly undesirable. Thick forests were
also to be avoided because of the restricted
circulation of air there. Where the army was
living in tents, the straw used for bedding
must be quickly changed should it become
damp, while officers should spread waxed
cloth on the damp ground under their
beds to keep out the moisture. When it was
raining, the tents should be tightly drawn to
lessen water penctration and drainage ditch-
es should be made around them. Camp-
sites and barracks should, of course, be
kept clean and free of accumulated garbage.
Privies should be built near the camp,
preferably over running streams. Even after
exercising all these precautions, however,
the army should avoid camping too long
in one place, especially “when bloody flux
prevails.” 32

Concern about the soldier and the weather
extended to the soldier’s clothing. Since sud-
den temperature changes, as occurred when
the soldier left a warm hut to go outside
in the winter, were considered particularly
dangerous, it was considered wiser in cold

1775-1818

 

JoHN JONES. (From Steven T. Charles, “John
Jones, American Surgeon and Conservative
Patriot,” Bulletin of the History of Medicine
39 (1965): 437. Courtesy of Johns Hopkins
University Press.)

weather to keep the men warm with extra
garments and blankets than with the crea-
tion of great heat by stoves or fires. Flannel
rather than linen, some authorities said,
should be worn next to the skin, especially,
of course, in the winter. At least one Ameri-
can authority strongly favored wearing flan-
nel underclothing even in the summer, since
it would prevent chilling if the temperature
were to drop markedly during the night.
John Jones, one of America’s foremost army
surgeons, however, believed that lighter
clothing should be worn in hot weather and
that linen, washable and cheaper to buy,
was preferable to flannel.??

Concern went beyond the soldier’s camp
and clothing to his personal hygiene. It
should be required that “no soldier be per-
mitted to ease himself anywhere about the
camp except in the privies.” He should bathe
© Ch.1]

frequently, in the running water of a warm
stream when possible, and wash his clothes
as often as he could. He should keep his
hair short or at least greased and combed
daily to avoid the buildup of dirt and per-
spiration on his head.?* Pringle believed
that even the amount of sleep the soldier
received should be regulated, since “when
soldiers are off duty, they sleep too much,
which enervates the body, and renders it
more subject to diseases.” Adequate exer-
cise was also most important.3?

Close supervision of what the soldier ate
and drank was necessary. Ideally he should
drink only from the center of a moving
stream or from wells giving pure water.
When this was impossible, impure water
should be mixed with vinegar or with chalk
or alum and then filtered. By the early
1800s, the presence of “animalcules” in
swamp water was recognized and boiling as
well as straining of questionable water was
urged. For hot weather use, Jones suggested
adding vinegar, highly regarded by many
for its supposed ability to preserve the
health in the summer. This mixture would
“serve to correct in some measure, the
natural tendency of the humans to corrup-
tion, at that season.” The drinking of bev-
erages stronger than water, however, caused
considerable discussion. Monro recom-
mended diluted spirits for soldiers scheduled
for night duty in cold weather, and Jones
agreed that something stronger than water
or “small beer” was necessary for men long
exposed to the cold and damp. The Ameri-
can Army surgeon Edward Cutbush, how-
ever, warned against giving out undiluted
spirits to soldiers and suggested that beer be
substituted for stronger liquors.3%

Defective diet was not classified as among
the most important causes of illness. Many
believed that, by having to contribute his
food allowance to a mess and thus being
unable to squander it on liquor, the soldier
was guaranteed an adequate diet. Some con-
cern was shown, however, that too much

State of the Art 11

meat was being eaten in proportion to fruits
and vegetables in the diet. Sugar was recom-
mended as a method of making vegetables
taste better, so as to lower the consumption
of meat. Others speculated as to whether
fresh fruit caused dysentery, Pringle believ-
ing it did not. Because of the concern for
the possibly harmful effect of meat, the
proportion of it given to hospital patients
was restricted for those on “low” and “mid-
dle” diets. By the early years of the nine-
teenth century, concern was also being
shown by Americans for the health of the
meat animals the Army used for its mess-
halls.?7
The only important deficiency disease gen-
erally recognized at this time was scurvy.
By mid-century, James Lind had conducted
experiments which showed to his satisfaction
that oranges, lemons, and limes cured even
the severest scurvy. By the time of the
American Revolution, van Swieten had
recognized that the eating of plenty of ripe
fruits and vegetables could prevent this con-
dition, but he and a surprising number of au-
thorities, including even Lind himself, contin-
ued to assume that additional factors were
also involved. Lind noted the importance
of “warm, dry, pure air, with a diet of easy
digestion, consisting chiefly of a due mix-
ture of animal and vegetable substances,”
adding that “a glass of good sound beer,
cyder, wine, or the like fermented liquor”
would be advisable.?® Van Swieten, as late as
1776, blamed scurvy on “Noisome vapours,
arising from marshy grounds, and stagnating
waters, inaction, drinking of corrupted and
stagnating waters, . . . damp and low lodg-
ing” as well as “scarcity of green vegetables,
. the use of salted and smoaked [sic]
flesh and fish, and of cheese too old and
acrid.” A number of others writing in the
period immediately preceding the Revolu-
tion expressed themselves along similar
lines.?® Nevertheless, Lind urged that the
army plant “antiscorbutic plants” where it
was garrisoned, suggesting, among others,
12 THE ARMY MEDICAL DEPARTMENT, 1775-1818

 

CONTRAST BETWEEN VACCINATION AND INOCULATION. Left, inoculation; right, vaccination.
Second and third days. (From Cecil Kent Drinker, Not So Long Ago (New York: Oxford
University Press, 1937.)
Ch. 1] State of the Art 13

 

CONTRAST BETWEEN VACCINATION AND INOCULATION. Left, inoculation; right, vaccination.
Fourteenth and fifteenth days. (From Cecil Kent Drinker, Not So Long Ago (New York:
Oxford University Press, 1937.)
14 THE ARMY MEDICAL DEPARTMENT,

“garden cresses,” and in 1776, the Conti-
nental Congress told its Medical Committee
to be sure to have sufficient antiscorbutics
on hand for the army operating in the North.
In 1808, an army physician commented that
if fresh fruits were impractical, an essence
could be made of oranges and lemons to be
used as a preventive for scurvy.’

The only disease for which prevention in
the form of immunization was available was
smallpox. Inoculation, the deliberate intro-
duction into the body of material infected
with the smallpox virus, thereby causing a
mild case of that disease, was widely used
during wartime by the British Army even
before the American Revolution, after its
initial introduction in both England and the
colonies in the 1720’s. The procedure ran
into much opposition, especially in New
England, in part because the person inocu-
lated became a source of infection for all
those with whom he came in contact. Many
areas, particularly in New England, hoped
to avoid smallpox merely because of their
isolation, yet the ultimate result of this
attitude was the appearance in the American
Revolutionary Army of a large number of
men who were not immune to the disease.
The method of inoculation most commonly
used in the colonies at this time was the
Sutton or Dimsdale method, named after
the Englishmen who developed it. As
adopted in the colonies, this method required
a two-week preparation period before inocu-
lation, during which the patient was put on
a diet of light and nonstimulating foods,
dosed with mercury and antimony, bled,
and purged. The inoculation itself was done
by means of puncture rather than incision,
as had been customary earlier, and on the
leg, so that it would be as far as possible
from the head and other vital areas. The
patients were put on a “cooling regimen,”
exposed to cool air, and permitted to drink
cool water while suffering from the disease
which, acquired in this manner, was reputed
to have become “an innocent disease” with

1775-1818

a death rate of one in 1,000, compared to
a rate of one in ten for smallpox caught by
unintentional exposure. Nevertheless, John
Cochran, soon to gain prominence as the
fourth Director General of the Army
Medical Department, wrote in 1772 of his
concern that the mercury given during the
smallpox inoculation process could lead to
other diseases once the patient had recov-
ered from the smallpox itself.*!

It was not until the very early nineteenth
century that Dr. Edward Jenner's method
of preventing smallpox by vaccination with
the cowpox virus became popular. By 1800,
Jenner had vaccinated about 6,000 patients,
and by 1804, his method had proved itself
by causing a dramatic drop in smallpox
deaths in both London and Vienna, with-
out bringing with it the risk of a general
epidemic. Although epidemics of smallpox
continued to appear in the United States
even after the introduction of vaccination in
1800, by 1812 the procedure had been ac-
cepted throughout most of the nation as a
replacement for inoculation with smallpox,
and in May 1812, shortly before the out-
break of the War of 1812, orders were is-
sued to Army surgeons to vaccinate the
entire Army using material from cowpox
vesicles. 2

SURGERY

While “Medicine ran into the cul de sac of
therapeutic nihilism . . . , surgery, with all
its imperfections . . . , could and did cure
with some confidence” in the eighteenth
century. By 1750, surgery was a respectable
profession. The work of John Hunter, who
was described as the first Englishman to
raise surgery to the level of a science, added
to its respectability, while the many wars
of the eighteenth century were giving sur-
geons opportunities for observations and
study which they otherwise would never
have had. American John Jones urged that
surgeons acquire as much learning and
Ch. 1]

training as possible * and took particular
exception to the idea he had heard suggested
that surgeons should operate only under the
direction of physicians, becoming merely
“surgical machines . . . under the direction
of their medical masters.” Jones also pre-
ferred that medicine and surgery be com-
bined, as it was to such a great extent in
the colonies.

A surprising variety of surgical procedures
was occasionally performed by a few eight-
eenth century surgeons, but such procedures
as lithotomy, or cutting for bladder stones,
setting of fractures, reduction of disloca-
tions, and amputations were very common.
The skill with which Jones was able to per-
form lithotomies when he returned from his
training abroad removed from this opera-
tion the bad name it had acquired in the
colonies. Jones was reported to be able to
perform a lithotomy in three minutes and
at times in one and a half, using a lateral
perineal approach. Other surgeons of the
time wrote of dealing successfully with torn
tendons, hydrocele, various types of her-
nias, and fistula lachrymalis, or abnormal
openings in the tear duct. In France, Louis
XIV’s successful surgery in 1686 for anal
fistula had inspired confidence both in
French surgeons and in this operation, while
the British surgeon William Cheselden had
attracted attention with, among other ac-
complishments, his successful operations for
cataract.’

Isolated reports of successful gynecologi-
cal and obstetrical surgery began to appear
in this period, proof that abdominal surgery
was not always undertaken in vain. Ameri-
can John Bard reported in 1760 on surgery
performed ten years earlier in which the
patient survived when he removed a dead
fetus resulting from an abdominal pregnan-
cy. In the following years there were other
scattered reports in the colonies of success-
ful surgery performed for ectopic preg-
nancies, and in 1809, the Edinburgh-
trained American physician Ephraim Mc-

State of the Art 15

Dowell performed his famed ovariotomy.
By the time of the American Revolution,
Jones could write of the proper handling of
penetrating wounds of the abdomen with
enough confidence and in sufficient detail
to make it obvious that he believed sur-
vival from such wounds to be possible. He
described the type of suture he used for
wounds in the intestine and discussed the
removal of sutures when the injury had
healed, as if the patient’s survival to this
point were not a total surprise. Among other
achievements in eighteenth century surgery
was the work of William and John Hunter,
with whom a number of the Continental
Army’s surgeons studied, in developing
a new surgical technique for handling
aneurysms, one soon followed by others.
There were also rumors in the 1760’s of a
splenectomy so well executed that the
soldier-patient was able to return to duty.
A successful appendectomy was performed
in 1759, although apparently little notice
was taken of it. Furthermore, before the
end of the century, the indomitable John
Hunter was experimenting with organ trans-
plants in chickens, moving the testicles and
spurs of cocks from one bird to another.
He also noted that “Teeth, after having been
drawn and inserted into the sockets of
another person, united to the new socket
which is called transplanting.” 46

Regardless of the nature of the injury,
the medical care the surgical patient was
likely to receive ran along familiar lines:
“moderate evacuation, by bleeding, and
gentle purging, together with a low diet.” 47
In addition, “when the wounded person has
not suffered any great loss of blood, it will
be advisable to open a vein immediately
and take from the arm a very large quantity,
and to repeat bleeding, as circumstances
require, the second, and even the third day.”
To be considered in the making of decisions
on bleeding the surgical patient, Hunter be-
lieved, was the violence of the inflammation,
the power of the patient’s body to make
16 THE ARMY MEDICAL DEPARTMENT,

 

PETIT'S SCREW TOURNIQUET. (From Owen H.
Wangensteen, Jacqueline Smith, and Sarah
D. Wangensteen, “Some Highlights in the
History of Amputation Reflecting Lessons
in Wound Healing,” Bulletin of the History
of Medicine 41 (1967): 115. Courtesy of
Johns Hopkins University Press.)

blood, the distance of the injury from the
sources of circulation, the nature of the part
injured, and the duration of the inflamma-
tion. **

Among the potions most highly regarded
by military surgeons were opium and bark,
usually peruvian or cinchona bark, the
source of quinine, praised in almost identical
terms by both Jones and British Army sur-
geon John Ranby, who extolled “the sover-
eign and almost divine power of opium;
next to this I likewise add bark, a medium

1775-1818

which no human eloquence can extol with
panegyric proportioned to its inestimable
victories.” Of bark he added, “I have known
it to procure rest, if given in large doses,
when even opium had been taken without
any manner of effect.” ¥* Van Swieten re-
garded the bark as the best available remedy
against gangrene, and John Jones maintained
that it contracted the blood vessels, “restor-
ing their due action upon the blood, when
too great a quantity of that necessary fluid
is lost by profuse haemorrhage, provided the
larger wounded vessels are secured by a
proper ligature from future bleeding.” On
the other hand, “where there is a great ful-
ness, or too much strength and contractile
powers in the solids, and an inflammatory
state of the system . . . the bark is not ad-
visable.” 50

Excess bleeding from a wound was one
of a number of problems with which eight-
eenth century surgeons wrestled. Although
crude tourniquets were used as early as the
sixteenth century to arrest hemorrhage be-
fore and during surgery, a new type of
tourniquet, developed by French surgeon
Jean Louis Petit in 1718 and tightened by
means of a screw, was now being employed.
The importance of proper ligation of major
arteries was well recognized. The use of
ligatures did not become popular for almost
a century after their initial appearance, how-
cver, partially because amputation above
the knee was not often performed, surgeons
being well aware of the fact that the danger
to the patient increased with the level of
the amputation, and because the cautery
was sufficient to control bleeding from
small-caliber vessels. Closure of the wound
was achieved with a variety of sutures. John
Hunter preferred to use, wherever possible,
the dry suture, since otherwise additional
points of infection could appear at the site
of each stitch, but he pointed out that the
dry suture was not appropriate for pene-
trating wounds. Four other types of suture
were also used after mid-century: the
Ch. 1]

twisted, then used in harelip repair and for
wounds presenting similar problems, and the
interrupted, quilled, and glovers’ sutures,
this last almost entirely for wounds of the
intestines or stomach. Both interrupted and
quilled sutures were used with abdominal
wounds, with the latter preferred. Jones
recommended the removal of sutures “as
soon as the union is complete, which gen-
erally happens either the second, or third
day, often in twenty-four hours.” The
double-flap technique for amputations had
already been developed, but the promotion
of healing by the first intention was con-
sidered to require great care and fore-
thought.®* It was suggested by Hunter for
“wherever a clean wound is made in sound
parts and where the surfaces can be brought
into contact, or where there is sufficient
skin to cover the part.” On the other hand,
wounds involving lacerations might be im-
possible to handle by the first intention,
while wounds which might contain foreign
matter should be left open so that pus
could bring any debris to the surface.?*

The care of the patient after surgery was
carefully supervised both to ensure appro-
priate care of the wound itself and to note
and treat possible complications. Hunter
believed that dry lint should not be used as
a dressing. Poultices were called for when
it was desired that the wound suppurate.
Where poultices were not appropriate, he
maintained that dry lint was likewise inap-
propriate. He suggested in these cases that
oil and wax or some other “unctuous mat-
ter” be used, or that it might even at times
be better not to use ointments. Jones
praised this British conservatism and added
that, if an ointment had to be used, it
should at least be very mild. The use of wine
and alcohol as a remedy against putrefac-
tion, however, was recommended by van
Swieten, while turpentine, used in the eight-
eenth century to combat minor bleeding,
now appears to have real value against bac-
teria.’®

State of the Art 17

The appearance of “laudable pus” was
regarded as a good sign, since suppuration
was considered to be the body’s attempt
to rid itself of harmful materials. Pus caused
a “very happy effect, by separating the
lacerated vessels and extravasated fluids
from the sound parts which then grow up
a-fresh. Hence laudable pus is esteemed by
surgeons as one of the best signs.” Redness
and heat around a wound were seen as
inevitable, as was fever in serious wounds.®*
It was expected that the various healing
processes might bring on a condition called
“the hectic,” the result of the body’s trying
unsuccessfully to heal itself and character-
ized by “debility, a small, quick, and sharp
pulse; the blood forsaking the skin; loss of
appetite; often rejection of all aliment by
the stomach; wasting; a great readiness to
be thrown into sweats; sweating spontane-
ously when in bed; frequently a constitu-
tional purging; the water clear.” > Once
“digestion of the wound” had taken place,
fever, inflammation, and pain could be ex-
pected to lessen. The average eighteenth
century surgeon was so unaware of the
causes and effects of infection that, when
a colleague achieved an unusually low mor-
tality rate, the explanation was sought in
his surgical techniques and not in his
standards of cleanliness.5¢

Among other possible complications aris-
ing in the wounded soldier was tetanus.
Thomas, in 1815, admitted the difficulty of
bringing a patient through tetanus and
stressed instead attempts to prevent it. He
cited among these efforts the Navy’s custom
of using a wound dressing containing tinc-
ture of opium and the use by a Dr. James
Clark of calomel before and after surgery
as a preventive. Rush noted in 1787 the
vast quantities of opium then routinely used
to treat tetanus, but stated that he person-
ally had effected a gradual but complete
cure by administering two to three ounces
of bark and up to three pints a day of wine
and raising a blister between the patient’s
18 THE ARMY MEDICAL DEPARTMENT,

shoulder blades to which he applied a
mercurial ointment.??

The types of surgery most commonly
performed in the Army involved, of course,
gunshot wounds and their consequences. By
the late seventeenth century, when it was
realized that the ball was not poisonous,
surgeons were urged not to probe deeply
but rather to let the ball remain if it could
not be located easily. Jones preferred to
dilate wounds to facilitate drainage or to
aid in the reduction of fractures, but Hunter,
believing that the edges of a wound were
quite elastic, concluded that enlarging the
opening was not required unless there were
severe hemorrhaging, a suspected skull
fracture, or debris or bone fragments to be
removed. Many surgeons now believed that
the caustic dressings once popular for gun-
shot wounds were no longer necessary.*®

When battle injuries involved fractures,
the question of amputation arose, many
surgeons favoring immediate amputation in
compound fractures. Such injuries, when
treated in crowded hospitals, were all too
frequently followed by infection, making
amputation eventually necessary even though
similar fractures, treated in a rural environ-
ment, might never require such drastic
measures. Van Swieten and John Hunter
preferred to postpone amputation until it
was obvious in each instance that it would
be required. Amputation did not necessarily
save the patient’s life, however. The mor-
tality rate was often 45 to 65 percent where
the leg was removed at mid-thigh, although
some surgeons lost markedly fewer patients
than this. Jones believed that immediate am-
putation was definitely advisable when the
heads of bones were broken or capsular
ligaments were torn. When the fracture in-
volved the skull, the danger posed to the
brain by excessive pressure was well recog-
nized and the eighteenth century surgeon
was prepared to trephine. The patient would
be fortified against these ordeals by the ad-
ministration of opium and, perhaps, rum

1775-1818

and his ears filled with lamb’s wool to
deaden the sound.?®

Although they were at times willing to
attempt a wide range of surgery, eighteenth
century surgeons generally acknowledged
their inability to save patients with wounds
involving the heart, aorta, cerebellum or
medulla of the brain, or the cisterna chyli.
Wounds of the spinal cord, major blood
vessels, or the principal organs of the chest
or abdomen were considered very danger-
ous. Amputation at the shoulder was gen-
erally avoided because of the danger of
hemorrhage. And, of course, anyone could
become fatally infected, a fact of which
army surgeons in particular were only too
well aware.%

MEDICAL EDUCATION
AND EXPERIENCE

Increasing numbers of young American
medical students were studying abroad; their
training added to the prestige of their pro-
fession in the colonies, although specializa-
tion in the European manner was rendered
impractical by the generally scattered popu-
lation of the colonies which required the
physician to become a medical jack-of-all-
trades, physician, surgeon, and apothecary
all in one. The medicine practiced by some
of these men carried purging and bleeding
beyond the extent customary in Europe, and
although physicians with European training
were at times most outspoken in their criti-
cism of the poor quality of American medi-
cine, it was often they who, like Rush, went
to those extremes which we today so deplore.
The social status of physicians at this time
could be great; they were found in colonial
legislatures and local assemblies, on college
boards, and among the wealthy merchants
and landed proprietors so influential in
colonial society.5!

It has been estimated that by 1775 ap-
proximately 3,500 physicians were prac-
ticing in the colonies, caring for a popula-
Ch. 1]

tion of three million, but that only 400 had
M.D. degrees from medical colleges. By
1776, the two medical schools then func-
tioning in America had conferred only 51
M.D. degrees. A majority of colonial phy-
sicians were either self-taught or taught
through apprenticeships; and of the approxi-
mately 1,200 medical practitioners serving
with the Continental Army in the Revolu-
tion, only an estimated 100 had M.D.
degrees. Among the leaders of the Army’s
Hospital Department, however, were some
of the best trained physicians in the
colonies.®? (See Appendix A.)

Training by apprenticeship was a highly
individualized process which varied with
the preceptor. Some required their appren-
tices to have a knowledge of Latin, natural
history, mathematics, and grammar, but
others were less demanding. Some appren-
tices might spend a large part of the tra-
ditional seven-year training period doing
menial and semimenial tasks, receiving at the
end of that time a certificate which was al-
most meaningless. %?

As the colonies became increasingly
prosperous, greater numbers of young Amer-
icans, including many future leaders in the
Continental Army’s Hospital Department,
went abroad for their medical education.
Proper preparation for such study was con-
sidered to include a college education fol-
lowed by three years of apprenticeship to a
physician who himself was well educated.
The British schools, which were at the height
of their popularity before the American
Revolution, included Edinburgh, where
clinical instruction was emphasized. Paris,
where surgery was increasingly respected,
became more popular with Americans after
the French Revolution. Colonial students at
this time usually studied in Paris only after
having received their M.D.’s, as did John
Morgan, William Shippen, Jr., and Benja-
min Rush after receiving their degrees from
Edinburgh. John Jones earned his M.D.
at Rheims before moving on to Paris to

State of the Art 19

study under eminent French surgeons. A few
individual European practitioners were es-
pecially influential, among them, of course,
Cullen of Edinburgh. In London, the Hunter
brothers, William and John, also played im-
portant roles in the lives of many American
medical students, including not only Rush
and Jones but also Morgan and Shippen,
both of whom were later Director Generals
of the American Army Medical Department
during the Revolution. John Pringle was
another strong influence upon young Ameri-
can students of surgery.%*

The first form of organized classes in
medicine in the colonies was a system of
lectures and demonstrations, often managed
by a physician whose training abroad led
him to feel acutely the need for better med-
ical education in the colonies. Classes in
human anatomy, however, were highly un-
popular among ordinary citizens, who asso-
ciated dissection with body snatching and
regarded it as a desecration of the human
body. Even postmortem examinations were
infrequent and their purpose was limited to
determining cause of death when murder
was suspected. Nevertheless, in 1762, Ship-
pen began a series of anatomy classes in-
volving both a human body and a series
of anatomical plates and casts donated by a
prominent London physician. His first class
held only ten students and triggered a
minor riot, Shippen being accused, despite
his denials, of grave robbing. The popular
assumption that dissection of the human
body implied body snatching lasted at least
until the 1788 Doctors’ Mob riot in New
York City when three days of violence, put
down only by military force, inspired the
first practical laws regulating such matters.%®

The first American medical school was
established in Philadelphia in 1765 by
Morgan. His failure to consult Shippen,
with whom he had formulated the early
plans for the school while both men were
studying at Edinburgh, added fuel to the
fire of the enmity already growing between
20 THE ARMY MEDICAL

the two men. Morgan was given the first
appointment as professor at the new school
where Shippen, who had been teaching for
several years in Philadelphia, and later Rush,
among others, joined him. Students at this
school were required to have studied Latin,
Greek, mathematics, and philosophy, and
Morgan strongly recommended a familiarity
with French as well. By the turn of the
century, three more medical schools were in
operation in the United States, at Kings
College, Harvard, and Dartmouth, all with
faculties in which foreign-trained physicians
predominated. ®®

By the time the Revolution broke out,
American physicians were no longer iso-
lated from the thought of their colleagues,
either those in their own communities or
those in Europe. Books and journals were
available to them, and scientific societies in
the more populous areas gave them a
forum where they were encouraged to pre-
sent their own ideas. Here again, however,
the shadow of things to come was cast by
the formation in Philadelphia of rival socie-
ties by groups led on the one hand by
Morgan and on the other by Shippen. Few
of the medical publications in circulation in
the eighteenth century were of American
origin, but a number of public and private
libraries were being created and foreign
authors became very influential, among
them not only the British Pringle and
Brocklesby but also the Austrian van
Swicten, French surgeons such as Jean
Louis Petit and Henri Francois Le Dran,
and many others. The influence of French
military medicine also appeared in the form
of translations of the French Journal de
Médecine Militaire which were circulated
in the United States from 1783 to 1790.67

Some of the men who were to join the
American Army Medical Department had
gained limited experience in military medi-
cine during the French and Indian War.
Morgan, for example, was an army surgeon
with the Pennsylvania militia at that time

DEPARTMENT,

1775-1818

and John Jones had taken part in the
British attack on Canada. Experience with
the British exposed some of the apprentice-
trained colonial physicians to a higher level
of practice than they had known before and
familiarized them with the lower level opera-
tions of an army medical department. Dur-
ing the Revolution, even such men as Benja-
jamin Rush, who had no previous military
experience, expressed a wish to see the
American Army Medical Department
modeled more closely upon its British
counterpart.%8

During this period, the British Army’s
medical department was headed by a council
of three civilians, usually prominent London
practitioners, functioning as Physician Gen-
eral, Surgeon General, and Inspector Gen-
eral. Under them an inspector general was
assigned to every twenty- to thirty-thousand-
man army, where yet another inspector gen-
eral served each division of four to five
thousand men. The principal, or general,
hospital for such an army might have 400
beds and a staff of six medical officers (in-
cluding a physician and two assistants, a
surgeon and one assistant, and an apothe-
cary) and fifty other workers. The need for
a sergeant to keep order among hospital pa-
tients was first recognized during the French
and Indian War, and two orderlies were ap-
pointed who could assist in maintaining
discipline. The British also emphasized hos-
pital sanitation, good air and ventilation,
and the prevention of overcrowding. It was
intended that each regiment have its own
surgeon and, in wartime, two assistants,
and its own hospital in a house or tent.
Fairly high standards were used in the
selection of physicians, but regimental sur-
geons bought their commissions without
showing any qualifications except that of
experience, although in this instance, after
the French and Indian War, higher standards
were being urged. Regimental surgeons
serving the Americans during that war
tended to be poorly trained. The sick and
Ch. 1]

wounded at times went untended for days,
no efficient system of evacuation was de-
veloped until the Napoleonic Wars, and
supplies and food were inadequate. The
troops occasionally suffered from jaundice,
and there was no evidence that the problem
of typhus was handled any better by the
British then than by the Americans during
the Revolution.®®

The practice of military medicine in the

State of the Art 21

eighteenth century by nations experienced
with the demands of war left much to be
desired, even by the standards of the time.
It could not, therefore, logically be expected
that the newly created Continental Army
Medical Department, directed by relatively
inexperienced men whose personal antip-
athies toward one another were rapidly
growing, could, in the early years of the
Revolution, function in a manner we would
find acceptable today.
2

Evolution of the Continental Army
Medical Department

The Continental Army's Medical Depart-
ment, established in July 1775, was assigned
an almost impossible task by the Continental
Congress. A staff for the most part totally
unfamiliar with military medicine, handi-
capped by a serious and chronic shortage
of drugs and by confused and inadequate
legislation, was expected to provide uni-
formly competent care for an untrained army
whose health was jeopardized by poor hy-
giene and frequently inadequate food and
clothing. Medicines and supplies were in

many instances imported and, even before

the war, often in very short supply. The
chain of command was confused because the
legislation establishing the department did
not recognize the existence of regimental
surgeons and regimental hospitals and, when
the scope of the medical service's activities
broadened to cover operations beyond Mas-
sachusetts, did not define the relationship of
the heads of the hospitals in other areas
to the original Director General. (Table
1) In an era when violent quarrels between
ambitious men were common, these legis-
lative omissions fueled disagreements and
even feuds which would threaten the Med-
ical Department with paralysis. Thus the
medical service was all too frequently un-
able to provide adequate and compassionate
care, even by eighteenth century standards,
for the Army’s ill and wounded.’

CREATION OF THE HOSPITAL
DEPARTMENT: CHURCH
AS DIRECTOR GENERAL

When George Washington arrived at Cam-
bridge, Massachusetts, on 3 July 1775 to

take command of the Continental Army,
the hospitalized sick and wounded, most of
whom were from Massachusetts, were being
cared for by Massachusetts regimental sur-
geons in Massachusetts facilities. It was
obvious to all concerned, however, that
this approach would be inadequate when
units from other colonies became involved
and when the fighting spread beyond the
confines of that colony. Washington pointed
out that already “Disputes and Contentions
have arisen and must continue until it is
reduced to some system.” 2

On 27 July, the Continental Congress, in
a brief resolution, created for a Continental
Army of approximately twenty thousand
men what was termed in the language of the
day “an Hospital” or, in modern terms, a
hospital system or medical department,
whose physicians were not, however, given
military rank. This piece of legislation, like
others to follow, was a source of consider-
able confusion, but the major problem at
this time was caused by the failure to out-
line the relationship of the new department
and its director to the existing regimental
system, organized by each individual colony
for the benefit of the regiments from that
colony.? (See Appendix B.)

The legislation creating the Hospital De-
partment also failed to discuss its relation-
ship to the Congress. In September 1775,
however, in response to the increasing seri-
ousness of the drug shortage, the Conti-
nental Congress created a Medical Com-
mittee “to devise ways and means for
supplying the Continental Army with Medi-
cines.” This new committee, to which a
Ch. 2]

Continental Army Medical Department Evolution

23

TABLE 1—AUTHORITY WITHIN THE CONTINENTAL ARMY'S MEDICAL SERVICES, 1775-83

 

Highest Authorities Within
Hospital Department

 

 

Date Highest Authorities Within
Highest Independent Regimental System
Authority Major Subordinates
July 1775 Director General and Surgeons, apothecaries Regimental surgeons

September 1775

June 1776

July 1776

September 1776

April 1777

August 1777

September 1780

March 1781 4d

 

Chief Physician

Director General and
Chief Physician;
Director General and
Chief Physician in the
North a

As above, Director
General and Chief
Physician in the
South 2

As above

As above

Director General

Director General;
Director of the
hospitals in the South

Director General;
Deputy Director
General for area south
of Virginia

Director General

 

Surgeons, apothecaries,
mates

As above

As above, including
surgeons functioning
as hospital directors

As above

Deputy Directors of
each district b

As above

Three chief hospital
physicians

As above, Deputy
Director in the South

 

As above

As above

Regimental surgeons:
must submit medicine
chests for inspection to
Hospital Department’s
hospital directors

Regimental surgeons
responsible to heads of
Hospital Department

Physician and Surgeon
General for each army;
reports to Deputy
Director for his districte

As above

Chief surgeon and
physician for each
army

As above

 

NOTE : Only the legislation of April 1777 and March 1781 gave the Director General supreme authority over all

medical services.

a His relationship to the Director General and Chief Physician was obscure.

® The Director General functioned as the Deputy Director in the middle district.
© The regimental system from this point onward was a part of the Hospital Department.

“ No further changes in command structure occurred during the Revolution after this date.

physician, Benjamin Rush, was first ap-
pointed in August 1776, was but one of
several which were to concern themselves
with the Hospital Department at one time
or another during the course of the Revolu-
tion. Its authority gradually grew, and by
early 1777, it had become involved in such
matters as the hiring and firing of Hospital
Department personnel, smallpox inoculation
policies, and the resolution of the internal
disputes of the Hospital Department.*

Rush failed of reelection to the Conti-

nental Congress in February 1777, and the
new Medical Committee which was formed
after the elections contained no holdovers
from its predecessor. Its responsibilities
were broadly outlined from the outset; it
was “to devise ways and means for preserv-
ing the health of the troops, and for in-
troducing better discipline into the army.”
Some type of Medical Committee appears
to have been in existence from this time
until its functions were assumed by the
Board of War in May 1781.%
24 THE ARMY MEDICAL DEPARTMENT, 1775-1818

Ot otis neal boyn

cn A He A Lorn on pial nts al
Pir ad Le
Srl a >

A TN b
AEN eal

TA

cs

) A ae a oe
re To Ml. lag” wre suri end chm
* aed tl trun eg oA Fook

Today Jot 37 Lye fee
ANA nico eon cement i

Te cop of tok fbn hen 7 ] ow |

les oe 4 pital ” Hoc frsrwarbrug

Grnt BSL de oo follow '
fpf oe uber ul ee ent

Lf .

boii dan Lesauaii

  

: eh
2 Sratespers AF VE Rey
! tars lowers tof Mp itp

 

ws

AcT CREATING HospPiTAL DEPARTMENT. (Courtesy of National Archives.)
Ch. 2] Continental Army Medical Department Evolution 25

70 :
. Rug hn oy
: Be fistin Redglis, Vin! busin ty fotos Foor ao a Solan,
yy OD Hod 7 lo Reese AL) A
rn esti to

. 2 de 2 Hod Melhores ity
i snd le Bucs be : Frsaterendte
Foon a

Dithppr of

 

aor prosdun will # .
No to Hoa Ain 0p Ppa for
fl Yfient 2 ry

2D stings Glink bay tomasssrront

wd Lp TLE

> A
Lr hn
Seng] i Hah thy 10g enc

rrr AA 1 pl $e

ee oc: :
SNE Buortedon * + . -
~ . -- \ » \ ow
26 THE ARMY MEDICAL DEPARTMENT,

 

BENJAMIN CHURCH. Apparently no picture of
Church taken from life exists. This portrait
was based on ‘‘contemporary description”
(James Evelyn Pilcher, “Benjamin Church,
Director General and Chief Physician of the
Hospital of the Army, 1775,” Journal of
the Association of Military Surgeons 13
(1903): 324). (Courtesy of National Li-
brary of Medicine).

Despite the existence of the Medical Com-
mittee, the Congress continued to involve
itself directly in the operations of the
Hospital Department. The shortage of drugs
eventually became so critical, however, that
even Committees of Safety from various
states joined the attempts to relieve it and
the search for medicines was expanded to
include France, Holland, and the West
Indies.®

To head the newly created Hospital De-
partment, the Continental Congress unani-
mously elected Dr. Benjamin Church of
Massachusetts as the first Director General
and Chief Physician.” Church was known
not only as a talented and well-educated
physician and surgeon but also as an enthu-
siastic poet-patriot, an author of Liberty

1775-1818

songs who played an active role in the oper-
ation of the hospital system for Massachu-
setts military units and in the examination
of candidates for positions as surgeons for
those units. He had received his medical
training in London, practiced in Boston, and
served Massachusetts as a member of both
the Provincial Congress and the Boston
Committee of Correspondence.

When Church assumed office, colonial
soldiers were being cared for in about thirty
hospitals, some of which were in wretched
condition under the management of sur-
geons who had little understanding of the
problems which faced them. He continued
within the new department the same policy
of examining candidates for medical posi-
tions which was originally followed in the
appointment of surgeons for Massachusetts
units and moved to consolidate hospitals,
ordering regimental surgeons to send their
patients, whenever possible, unless their
complaints were very minor, to the general
hospitals. Massachusetts surgeons generally
cooperated with Church’s efforts, but those
from the regiments of other colonies gen-
erally did not.8

Many believed that the smaller hospital
intended for the care of the ill and wounded
of a four-hundred- to five-hundred-man
regiment was less hazardous to the health
of its patients than the large general hospital.
It was also true that soldiers felt more secure
when cared for by their own doctors among
the men of their own units. General hos-
pitals, however, were reputed to be more
efficient and to have better staffs, since regi-
mental surgeons and mates were a motley
crew named by their respective colonels and
their competence was not necessarily tested
before appointment.®

Church found that the costs of running
the regimental hospitals were extremely high
and believed that this indicated the existence
of “inexcusable neglect” on the part of the
regimental surgeons managing them. He
wished to have patients moved to general
hospitals rather than to have medicines
Ch. 2]

issued to regimental surgeons to permit them
to continue to care for their patients. By the
end of August, although he acknowledged
organized resistance to his plans, Church
believed that he was making progress in his
fight against the supporters of the regimental
hospital. He was sure that the soldiers them-
selves appreciated the advantages of the
hospitals he had established and claimed
that regimental surgeons had begun to seek
out mates’ berths in the general hospital.!?
In early September, Washington expressed
support for the general hospital concept,
commenting, “there is no need of regimental
Hospitals without the Camp when there is
a general Hospital so near and so well ap-
pointed.” 11

The opposition continued, however. Regi-
mental surgeons complained to their officers
whenever the general hospital denied them
the drugs they demanded. Brig. Gen. John
Sullivan protested that his wounded were
being moved three to four miles to Cam-
bridge to have their wounds dressed while
his regimental surgeons stood virtually idle.
His officers continued to bring pressure upon
him: “Are the Dolorous Groans of the
Disconsolate, agreeable to any human Ear—
That they should be still Increas’d by Drag-
ging our sick . . . In Waggon Loads to
Cambridge? Humanity shudders at the
Prospect.” General Sullivan insisted that ful-
ly half of the patients ordered by Church
to the general hospitals refused to go, “De-
claring they would rather Die where they
were and under the care of those Physicians
they were acquainted with.” The period of
enlistment for the Continental Army at this
time was for one year, making it necessary
to raise a new army at the end of the
soldiers’ terms. Consequently the effects of
the controversy over medical service on the
morale of the average soldier were of great
concern. General Sullivan commented, “I
greatly fear that if it does not Ruin the
present Army [it will] prevent another be-
ing raised in America.” 12

Although a second problem which

Continental Army Medical Department Evolution 27

plagued the Continental Medical Depart-
ment, that of the Director General's au-
thority within the expanding Continental
medical establishment, did not appear in its
ultimate dimensions under the Church ad-
ministration, its foundations were laid in
September 1775 when Dr. Samuel Stringer
was appointed “director of the Hospital,
and chief Physician and surgeon for the
Army in the northern department.” Stringer
was to be paid a salary equal to Church’s
and had the right to appoint four men to
serve under him. These men, however, were
to be surgeon’s mates, not surgeons, imply-
ing that Stringer’s position was comparable
not to Church’s but to that of a surgeon.
Although Church was clearly supreme with-
in the establishment centered at Cambridge,
Congress had failed to define either the rela-
tionship of the new system in the north to
the one in Massachusetts or Stringer’s posi-
tion in the chain of command and had thus
created fertile ground for future quarrels.!3

It was in the midst of his struggle with
the advocates of the regimental hospital
that Church fell from power. By September,
the quarrel between the two factions was so
intense that Washington ordered that an
investigation be conducted within each bri-
gade. He required each brigadier general to
sit with his officers as a court of inquiry
into the various complaints, talking to both
the Director General and the regimental
surgeons. On 20 September, after three such
hearings, Church attempted to resign, but
Washington urgently requested the doctor to
consider the matter at greater length. The
final hearing was planned for 30 September,
but on that day Washington announced the
postponement of this last inquiry because
“of the Indisposition of Dr. Church.”14

The true reason for the postponement,
however, was the discovery of a letter from
Church to a British officer within British-
occupied Boston. It had been suspected for
some time that someone in the Provincial
Congress of Massachusetts was informing
to the British, but Church had explained his
28 THE ARMY MEDICAL DEPARTMENT,

own suspicious friendliness with an enemy
officer as an effort to keep himself informed
of enemy activities. Washington now learned
of a letter written the preceding July which
had been left with a patriot by the ‘“in-
famous hussy” who had been asked to
deliver it. His suspicions aroused by her
obvious anxiety, the patriot had offered to
take the message into Boston for her. Al-
though written in cipher, the letter was
easily decoded and the woman, questioned
by Washington himself, finally confessed
that Church was the author. An immediate
search of the doctor’s papers, however, re-
vealed nothing incriminating, leading the

general to conclude that a protégé of
Church’s had removed anything suspi-
cious.1®

The letter was, according to John Adams,
“the oddest Thing imaginable. There are so
many lies in it, calculated to give the enemy
an high Idea of our Power and Importance,
as well as so many Truths tending to do
us good that one knows not how to think
him treacherous: Yet there are several
strokes, which cannot be accounted for at
least by me, without the Supposition of
Iniquity.” Indeed, it was only in the period
immediately preceding World War II that
the discovery of Church’s letters to the
British General Gage definitely proved that
he had been sending secret military and
political information to the British for six
weeks before the battle of Lexington. Until
that time, many others shared Adams’s un-
certainty. Church himself claimed that the
letter was intended for his Tory brother-in-
law in Boston and was designed to bring
about a delay in the British attack which
was anticipated when their momentarily ex-
pected reinforcements arrived, since colonial
forces were still weak. James Warren and
Samuel Adams, however, noted as significant
the fact that Church had apparently never
mentioned the correspondence to George
Washington or, indeed, to any of the patri-
ots.1¢

1775-1818

While Washington laid the question of
how to proceed before his generals on 3
October 1775, Dr. Isaac Foster (also spelled
Forster), head of the Massachusetts mili-
tary hospital system before the creation of
the Continental system, was appointed acting
Director in Church’s place. The next day,
Washington’s Council of War unanimously
decided that Church had been caught in
“criminal correspondence with the enemy.”
Close examination of the Articles of the
Continental Army revealed, however, that
the only punishment which the Army could
legally inflict upon Church for this treason
was cashiering and either the loss of two
months’ pay or thirty-nine lashes. Further
legal problems arose from the fact that the
alleged crime was committed before
Church’s appointment to the Army post and
that the letter, the only evidence then avail-
able of his treason, was never actually de-
livered.1?

Washington turned to the Continental
Congress for a way out of this dilemma,
but with the decision of that body on 14
October 1775 to elect a new Director Gen-
eral, Church passed beyond the scope of
this history. It might be added, however,
that although the Continental Congress and
both Massachusetts and Connecticut at-
tempted to find some satisfactory way to
dispose of this case, none was ever found.
Commented John Adams in June 1776,
“Nobody knows what to do with him.
There is no law to try him upon, and no
court to try him. I am afraid he deserves
more punishment than he will ever meet.”
Church’s health began to fail, however. and
he was permitted to board a ship bound
for the West Indies. Neither he nor the
ship was ever heard from again. His widow
successfully applied to the king for a pension
as the widow of a loyalist, claiming that
her husband had been imprisoned for serv-
ices rendered the British crown.8
Ch. 2]

DIRECTOR
1777

MORGAN AS
GENERAL, 1775 TO

On 17 October 1775, Dr. John Morgan
was selected by the Continental Congress
over three other official nominees to be
Director General. Morgan was not Wash-
ington’s first choice, however, since the
general wished to see his young friend, Dr.
William Shippen, already Morgan’s rival in
their home town of Philadelphia, take the
post.1®

Although the quality of Morgan's mind
and training was undeniable, the honors he
had received were many, and his “moral
character” was deemed “very good” by
John Adams at the time of his selection,2®
none other than James Boswell, Samuel
Johnson’s famous biographer, who joined
the youthful Morgan for a tour of Holland
in August 1763, called him “un fat
bonhomme,” translated by Morgan biog-
rapher, Whitfield Jenks Bell, Jr., as “a
conceited fool.” 2! Several years after Mor-
gan’s dismissal from the department, Dr.
Barnabas Binney called him “the most im-
placable, revengeful man under the Heav-
ens.” 22 Morgan, Bell has stated, always
suffered from “the same tension between the
ideal and the possible, the same conflict
between what he knew ought to be and
what in the actual circumstances could be,
and the same inability to understand the
difference.” Unable “to see anything touch-
ing himself in normal perspective,” 22 Mor-
gan was driven by the demands and
disappointments he experienced as Director
General of the Continental Hospital Depart-
ment to the point where vengeance upon the
man he eventually blamed for his every
frustration became his main goal in life.

Morgan was appointed Director General
in October, but before actually reporting
for duty, he took a month to put his personal
affairs in order and to collect drugs and in-
struments. Washington was sufficiently
distressed by the delay to point out that

Continental Army Medical Department Evolution 29

 

JOHN MORGAN. (Courtesy of Historical Society
of Pennsylvania.)

Morgan’s presence was most urgently re-
quired at camp and that the Director “ought
not to delay his departure for the camp a
moment, many regulations being delayed,
and accounts postponed, till his arrival.”
When he finally did arrive in Cambridge,
Morgan was confronted with hospitals
crowded with the victims of various diseases,
Army officers inexperienced with the main-
tenance of the health of large numbers of
men, and a department already experiencing
increasing difficulties keeping up with the
demand for supplies. The problems posed
by two parallel and conflicting medical sys-
tems were by no means diminishing, while
those posed by conflicting authorities within
the department were just beginning, 24
Seemingly undaunted, Morgan inspected
the entire department and its operations. The
stock of medicines and hospital supplies on
hand proved to be totally inadequate. There
were almost no blankets, for example, al-
though there were more than 500 mattress
30 THE ARMY MEDICAL DEPARTMENT,

\)

i] | eo he 3 Yt

Ee

SURGEON’s FIELD CASE. (Courtesy of

ticks. There were only 200 bandages and
little in the way of materials from which to
make more. The report on drugs from the
apothecary revealed that, although 120 dif-
ferent items were on hand, the supply of
some of the most highly regarded medicines
was very limited.2®

Medicines were being brought in from
Philadelphia, but they came in slowly while
the number of soldiers in the area increased
rapidly. Morgan’s position required him to
deal with the supply crisis directly. Instru-
ments were so difficult to obtain that he was
reduced to suggesting to one surgeon that he
use a razor blade as an incision knife. He
succeeded, nevertheless, in equipping chests
for regiments both in Boston and elsewhere.
The wool and woolen cloth so highly val-
ued by many eighteenth century military
physicians were hard to obtain, although
some was purchased on credit in France.
The general shortage of textiles meant that
even tent materials were in short supply.
Congress rarely voted enough money to
meet the department’s needs, and Wash-

1775-1818

   

Armed Forces Institute of Pathology.)

ington further complicated the problem in
December 1775 by underestimating the costs
of supporting the hospitals required by the
Army.?¢

The conflict between the Hospital Depart-
ment and the regimental medical system
which caused so many difficulties under
Church also continued under Morgan and
was intensified by the shortage of medi-
cines and hospital supplies. Morgan’s neces-
sarily meager release of supplies from the
general hospital to regimental surgeons,
which was in part caused by his desire to
stockpile stores against future need, only
served to heighten the tensions already
existing between the two systems. Regimen-
tal surgeons assumed that they had a right
to draw on the general hospital’s stores and
blamed hospital surgeons for the shortages
which they experienced, but Morgan main-
tained that he had no orders to supply regi-
mental needs. Since he was unable to ac-
count for the way in which regimental
surgeons used what they drew, he believed
it necessary to limit carefully what they were
Ch. 2]

issued. Morgan did think, however, that the
regimental hospital served a useful pur-
pose and was even reasonably confident of
his own ability to handle the situation if
Congress would clarify the legal relation-
ship between the two systems. Morgan be-
lieved it was essential that the regimental
surgeons, whose number was increasing as
new regiments were formed, be “placed in
some subordination.” He asked Congress to
inform him whether regimental surgeons
were subject to any rule “that may be de-
vised for the government of the Hospital,
and the good of the service.” #7

Morgan was expected to participate in
the preparation and issuance of medicine
chests and the instruments and drugs in
them to regimental surgeons. Since new
regiments were being formed rapidly at this
time and supplies were running short, find-
ing the items necessary for these chests was
quite difficult. Morgan realized, however, the
potential threat to the general hospital which
would arise should regimental surgeons
choose to alleviate the strain on their sys-
tem by turning all their patients over to the
Hospital Department. He predicted to Wash-
ington that the population of the general
hospital might be increased by such an ap-
proach from the approximately 300 there
at that time to 2,000 and therefore sug-
gested, with Washington’s concurrence, that
regimental and general hospitals be brought
into harmony. On 17 July 1776, however,
Congress itself finally passed legislation
which, while to some degree officially clari-
fying the relationship of the two medical
systems as far as supplies were concerned,
failed to eliminate ill feeling. (See Appendix
C.) The resolve stated that regimental sur-
geons were not to be permitted to draw
anything but medicine and instruments from
the Hospital Department and that patients
whose treatment required anything more
were to be sent into the general hospital.
The directors of individual hospitals were
entitled to inspect the regimental chests and

Continental Army Medical Department Evolution 31

surgical instruments; if regiments were re-
duced in size, instruments and medicines
not being used were to be turned over to the
Director General who would report on their
number to Congress. Regimental surgeons
also were required to submit returns on
the number of sick under their care to the
Hospital Department.28

This new act also permitted an increase
in the number of Hospital Department
surgeons and mates up to one surgeon and
five mates for every 5,000 men and the
hiring of as many storekeepers, stewards,
nurses, and other hospital employees as
deemed necessary, to be appointed by
individual hospital directors. The suggestion,
favored by Morgan, that hospital expenses
be met at least in part by a deduction from
the pay of each soldier did not pass, but
some economies were achieved by stopping
the regular rations of the sick as long as
they were in the hospital. Hospital directors
were required to give the names of the sick
and dates of their hospitalization to the
commissary and to the Board of Treasury
to ensure accurate accounting.??

Unfortunately, neither Morgan’s efforts
nor those of the Continental Congress had
much alleviated the conflict between the
two systems. Complaints against the gen-
eral hospital continued, and at least one
colonel, Maryland’s Smallwood, removed
his men from the general hospital and re-
fused to have others enter it, commenting
that they were better off housed “in a com-
fortable house in the country, and supplied
with only common rations.” The Conti-
nental Congress forbade the placing of regi-
mental hospitals near general hospitals and
ordered commanding officers to send an
officer once a week to check on the con-
dition of their men in department hos-
pitals.2°

Many thoroughly distrusted regimental
surgeons. Washington had been disillusioned
by the facts brought out at the hearings of
the preceding September and called regi-
32 THE ARMY MEDICAL DEPARTMENT,

mental surgeons “very great Rascals” wil-
ling to certify as sick those who were
perfectly healthy. These surgeons were
“aiming, I am persuaded, to break up the
Genl. Hospital.” Their bickering was en-
dangering the entire army and their insistent
demands for furniture and accommodations
were resented by Morgan, who could not
legally accede to their wishes. Washington
now believed that only the subordination of
regimental surgeons to the Director General
would resolve the problem, but others
maintained that the controversy could be
ended by a firm decision either to take
everyone who was too ill to perform his
duties into the general hospital or to have
the general hospital provide regimental sur-
geons all they needed to care for their pa-
tients. Unfortunately, however, because of
the shortage of medicine and hospital sup-
plies, the Hospital Department was in no
position to undertake either alternative.®!

Regimental surgeons were also dissatisfied
because, while they received only $25 a
month, a sum raised in June 1776 to
$3314, and regimental mates were paid
but $18 a month, hospital surgeons re-
ceived $40 a month from the outset and
hospital mates $20. (See Appendix B.)
Appeals to Congress resulting from the
conflict between the two systems poured in
even as a tendency to partisanship among
the members of Congress grew and medical
policy became highly controversial. The
tension was increased by suggestions that
it might not be possible to raise more troops
unless the medical service was reformed.
Congress’s resolution of 30 September 1776
subordinating regimental surgeons to the
heads of the divisions of the Hospital De-
partment did not end the controversy.??
(See Table 1.)

Meanwhile, the confusion about the Direc-
tor General's authority over the Director of
the Hospital in the Northern Department
had come to a head. Dr. Samuel Stringer
took his post in the North in September

1775-1818

1775, a month before Morgan’s official ap-
pointment. He apparently set to work at
once to carve out an independent niche
for himself among the troops under Maj.
Gen. Philip Schuyler gathering for an in-
vasion attempt against Canada. Saying that
the four mates allowed him earlier were not
enough, Stringer asked Congress in late
October 1775 to assign him surgeons and
more mates. Were surgeons assigned to
work under him, his own position would,
of course, be strengthened.

By 1776, an all-out three-way power
struggle was developing, with Stringer at-
tempting to maintain his own independence,
Morgan attempting to “subordinate” String-
er, both physicians scheming to receive the
support of Congress for their own ambitions,
and Congress refusing to be pushed or ma-
nipulated by anyone into clarifying the situa-
tion. Washington himself urged that
Congress set one single head over the entire
Hospital Department. Stringer’s request in
May 1776 for an increase in his staff to a
total of four surgeons, twelve mates, and
other lesser figures was granted by Congress
on 22 May in terms which did not make
clear who was to name these men. Stringer
now also informed Washington that his
supply of medicines was totally inadequate
for his predictable needs, but Washington
referred the request for supplies to Morgan,
implying by so doing that Stringer’s posi-
tion was subordinate to Morgan’s.33

By June, Morgan was demanding that
Congress clarify the situation. “From all I
am able to learn,” he commented, “every-
thing in the Medical Department in Canada
displays one scene of confusion and anarchy;
nor have the Congress taken upon itself to
establish . . . any person whatever with a
power sufficient to establish a General Hos-
pital in Canada.” The positions of Stringer
and Dr. Jonathan Potts, recently sent north,
were unclear. Morgan warned that the sur-
geons in Canada were spreading smallpox
through unwisely handled inoculation, some-
Ch. 2]

thing which did not happen, he insisted,
where he was in control. Help was badly
needed everywhere in the North, further-
more, and he recommended that he be
given permission to appoint more surgeons,
mates, and apothecaries so that he did not
have to send men already on duty and
needed in the New York City area. Stringer,
however, although he admitted the difficulty
of finding surgeons and mates, refused to
accept the officers sent by Morgan in re-
sponse to his stated need.3*

The solution Morgan proposed to prob-
lems in the North was the establishment of
a general hospital in Canada and the plac-
ing of all Hospital Department operations
in the North under his own authority. The
department as a whole would operate more
smoothly if he, as Director, chose all sur-
geons, since unhappy effects would result
from any undermining of “that idea of sub-
ordination so necessary in an Army.” He
boldly stated that “some resolves of Congress
have been incautiously entered into . . .
or titles of rank and distinction given, which
have a tendency to interfere with mine.”
The public, however, not understanding the
situation, tended to blame only Morgan for
conditions existing under Stringer’s com-
mand. Stringer and Morgan continued to
importune Congress, and Stringer even left
his post in the guise of seeking a supply of
medicines to pursue the matter personally
with Congress. The response of Congress,
however, was to state rather vaguely that
Stringer had been appointed “director gen-
eral and physician for the hospital in the
northern department only” and to add that
each hospital director was entitled to ap-
point his own subordinates unless Congress
directed otherwise.3®

Congress, indeed, was so little impressed
with its own share of the responsibility for
the conflicts among the medical officers
serving the Continental Army that in June
1776, on the urging of the Virginia Con-
vention, it created yet another hospital sys-

Continental Army Medical Department Evolution 33

tem, this time in Virginia, headquartered at
Williamsburg, where Dr. William Rickman
was appointed Physician and Director Gen-
eral.38

In September, one of Morgan's friends
and supporters in the Continental Congress,
Thomas Heyward, Jr., returned to South
Carolina, after informing Morgan that he
would not be able to continue to help him.
Congress, meanwhile, was harried and
harassed by the number and seriousness of
the problems with which it had to deal and
by late 1776 was apparently running out of
patience with both Stringer and Morgan.
In November 1776, Oliver Wolcott of the
Continental Congress ominously commented
that he hoped that “the Medical Department
will undergo a Reform of Men at least, if
not of Measures, that not so much Com-
plaint which I fear has been too well
grounded, may be heard respecting the
Conduct of that Department.” 87

Morgan’s position was further undermined
in the last six months of 1776 by a quarrel
with another Hospital Department physician.
His opponent in this instance was more
dangerous to him than Stringer, for Dr.
William Shippen was talented, charming,
superbly trained, highly regarded, and well
connected by reason of both his own Phila-
delphia family and his marriage to a mem-
ber of Virginia's influential Lee family. De-
spite Washington’s desire to see him become
Church’s successor, Shippen had not joined
the Hospital Department until the summer
of 1776, when he became chief physician to
the flying camp under the command of Gen.
Hugh Mercer, himself a physician. This
organization was composed of militia and
state troops called in on short enlistments to
form a strategic reserve in the emergency
created by the impending British attack on
New York, but it apparently never reached
its 10,000-man goal.

The appointment of a man he already re-
garded as a dangerous rival alarmed Mor-
gan, who later maintained that Shippen’s
34 THE ARMY MEDICAL

 

WILLIAM SHIPPEN, JR. (Courtesy of National
Library of Medicine.)

assumption of the post was part of a plot to
take his place. The wording of the notifica-
tion sent to Shippen, however, casts some
doubt on Morgan’s theory, since the phrase
“should you accept the appointment” implies
uncertainty as to Shippen’s acceptance. By
the fall of 1776, however, Shippen may have
been thinking in different terms, since he let
it be known that he was available should
there be changes in the structure of the
Hospital Department.38

On 9 October 1776, and apparently with-
out consulting Washington, the Continental
Congress once more produced a confusing
resolve. Shippen was directed to “provide
and superintend an hospital for the army, in
the state of New Jersey” and Morgan one
“for the army posted on the east side of
Hudson’s river.” There was, in this instance,
again no definition of the relationship of the

DEPARTMENT,

1775-1818

two men, even though the Congress did
detail carefully how the hospitals were to
be managed.

The month was not over before Shippen
wrote Washington that, although Congress
had assigned him all army patients on the
New Jersey side, Morgan had told all
medical officers to follow only the Direc-
tor’s orders until either he or Washington
told them otherwise. The basic issue, in
Shippen’s opinion, was whether he was to
give orders only for patients of the flying
camp, as Morgan seemed to think, or for
all sick and wounded in New Jersey, as
Congress, in Shippen’s opinion, intended.

Washington apparently assumed that those
of his men who retreated from New York
to New Jersey nevertheless remained the
responsibility of Morgan, as chief physician
for the main army; he stated that he inter-
preted the resolution to mean that Morgan
should hospitalize and care for patients of
the main army wherever he found it to be
most convenient, on either side of the river,
and that Shippen should restrict his care
to the men of the flying camp. He noted
that the problem would in time probably
solve itself, since wounded soldiers were
now beginning to return to the army and
Morgan would soon no longer need facili-
ties on the Jersey side.

Shippen, declaring his own confusion,
turned to General Mercer, who suggested
that Shippen appeal for clarification to
Congress. This Shippen did, commenting
that Washington seemed to make no distinc-
tion between Shippen’s original appointment
in July and Congress’s newer directive of
October. The response of that body to
his appeal was to state that all the sick in
New Jersey were Shippen’s responsibility.3?

Morgan’s position by December 1776 was
very weak, and he blamed Congress for
tying his hands by undermining his authori-
ty. Congress ordered investigations into the
department and there were calls for reform.
Shippen, in writing to his brother-in-law in
Ch. 2]

the Continental Congress, Richard Henry
Lee, referred to directors who were not
directing and noted that the care of the sick
was being delegated to ignorant mates while
surgeons and physicians found other things
to do. Shippen presented a detailed plan to
reform the Hospital Department, one which,
he maintained, would have among its vir-
tues the elimination of any need for regi-
mental hospitals. Washington pointed out,
however, that the clash between Morgan
and Shippen greatly increased the sufferings
of the sick in 1776.4°

On 9 January 1777, without warning, the
Continental Congress passed this brief re-
solve: “Resolved, That Dr. John Morgan,
director general, and Dr. Samuel Stringer,
director of the hospital in the northern de-
partment of the army of the United States,
be, and they are hereby, dismissed from any
farther service in said offices.” #1 Washing-
ton, in his letter of 18 January notifying
Morgan of his dismissal, noted “What oc-
casioned the above Resolve I cannot say, I
can only assure you, it has not been owing
to any representations of mine.” The gen-
eral confessed that he was “amazed to hear
Complaints of the Hospital on the East
Side of Hudson’s River; Doctr. Morgan, with
most of his Mates has been Constantly
there, since I left with the main body of the
Army” and stated his belief that Morgan had
also done his best to keep costs down.%?
Samuel Adams, however, writing to his
cousin John Adams the day the resolve was
passed, commented that both men were
“dismissed without any reason assigned”
and added that Congress had a perfect right
to proceed in this manner. Echoing earlier
comments by critics of Church’s administra-
tion, Samuel Adams added, “The true rea-
son, as I take it, was the general disgust, and
the danger of the loss of any army arising
therefrom,” since “Great and heavy com-
plaints” had been expressed concerning
“abuse in the Director-General’s department
in both our armies; some, I suppose, with-

Continental Army Medical Department Evolution 35

out grounds, others with too much rea-
son.” 43

Because of the abrupt nature of Morgan’s
dismissal, neither the charges against him
nor his defense initially received an airing.
Morgan, however, spent many long months
working first to clear his own name and then
to bring about the disgrace of his successor.
His pride had been severely hurt and he
made no secret of his bitterness. He ex-
plained:
. .. to be stripped of the rank of Director Gen-
eral, of the power of my station, and to be
left but the shadow of a Director, and yet to
be accountable for every accident, or miscon-
duct of others, as well as my own department,
and, from the highest post, to be rendered the
mere dependent of a junior and subordinate
officer, was what I would never submit to.

The source of all his miseries, the “junior
and subordinate officer,” was William Ship-
pen, Jr.4

Morgan was not officially cleared of all
charges of wrongdoing in office until June
1779, in part because of his attacks on
others. In his Vindication of himself, he
furiously attacked Shippen rather than limit-
ing himself strictly to the matter at hand.
One of Morgans supporters in Congress
drew censure from its President for altering
Morgan’s official appeal after its formal
presentation to Congress in an attempt to
make the document less vitriolic. It was,
therefore, only on 12 June 1779 that Con-
gress resolved that Morgan “did conduct
himself ably and faithfully in the discharge
of the duties of his office.” He was never
reinstated. *5

NEW ARRANGEMENTS FOR
THE HOSPITAL DEPARTMENT

Benjamin Rush, who was still a member
of the Medical Committee, reacted quickly
to the dismissal of Morgan, writing on 14
January to Richard Henry Lee to urge that
the appointment of a new Director General
be held in abeyance until the two men could
36 THE ARMY MEDICAL

 

BENJAMIN RusH. (Courtesy of the University
of Pennsylvania.)

discuss the matter. He stated that he wished
to give Lee the names of men who, like
John Cochran, were so able that they should
be appointed at once to high positions on
the department’s medical staff. He also
wished to advise Lee on the reform of the
Hospital Department, which, he believed,
should be designed more along British lines
in order, for example, to further remove the
responsibility for obtaining supplies for the
department from the office of the Director,
so as to minimize the possibility for cor-
ruption. *¢

Shippen, also impressed by the British
system, continued to work on his plan for
hospital reform, at Washington’s request
with the aid of the same Dr. Cochran whom
Rush so much admired. This plan suggested
the appointment of purveyors to manage
supplies received by the Hospital Depart-
ment and of an Inspector General to in-
spect hospitals and apothecary shops. The
general, who made it plain that he still
wished to see Shippen become Director,

DEPARTMENT,

1775-1818

was not sure that the higher salaries recom-
mended by Shippen would be granted, al-
though he himself felt them necessary, and
pointed out that the Shippen-Cochran plan
did not differ fundamentally from the ideas
favored by Morgan himself.47

In response to Washington's urging, a
special committee was appointed by Con-
gress on 22 March 1777 to study the health
problems of the Army. The report they is-
sued was repeatedly brought up for con-
sideration in late March and early April,
but its consideration was also repeatedly
postponed, often with suggestions for minor
alterations. The absence of a Director Gen-
eral and the uncertain nature of future
organization gave cause for concern to those
who held responsible positions under the
old system. Washington found it necessary
in at least one instance to reassure an anx-
ious medical officer that those who had been
performing their duties faithfully had noth-
ing to fear.*®

At last, on 7-8 April 1777, legislation
changing the organization of the Hospital
Department, much along the lines suggested
in the Shippen-Cochran plan, was passed by
the Continental Congress. (See Appendix
D.) Nothing in the new resolve suggested
that the Director was not the head of the
entire department. Among his many duties
was to be the personal supervision of the
hospitals of the Middle Department, between
the Hudson and Potomac Rivers. The
Eastern and Northern Departments, sepa-
rated geographically by the Hudson River,
were each to be managed by a Deputy
Director General; a third Deputy Director
would supervise hospitals south of the
Potomac River if the military situation
seemed to require the establishment of a
formal organization in this part of the
country. The new law implied that the rela-
tionship of this last deputy to the Director
General would be identical with that of his
counterparts to the north. Assistant Deputy
Directors, with the hospital surgeons and
Ch. 2]

attendants who would serve under them,
an apothecary general with his mates, and
a commissary with his assistants were to
work under each Deputy Director General.

In each geographical division (casually
referred to as either a department or a dis-
trict), the practice of medicine was to be
supervised by a Physician General and the
practice of surgery by a Surgeon General.
In addition, a Physician and Surgeon Gen-
eral would be attached to the army in the
Champlain area of the Northern Depart-
ment, a second to the units in New England,
in the Eastern Department, and a third to
the army personally commanded by Gen-
eral Washington, for the specific purpose of
supervising the work of the regimental sur-
geons and their mates and the management
of regimental hospitals. These officers would
be responsible to the Director General and
to the Deputy Directors General of the
districts in which they were serving.

Among the features of the original Ship-
pen-Cochran plan not found in the new
legislation were the positions of the Pur-
veyor, whose office was so important in the
thinking of Benjamin Rush, and of the In-
spector General. As a result of the elimina-
tion of these positions, the management of
the department’s supplies, as well as the
responsibility for the condition of the de-
partment’s facilities, remained entirely in
the hands of the Director General, although
the Medical Committee was empowered to
inspect any aspect of the Hospital Depart-
ment at any time.*?

The reaction to the new plan for the
Hospital Department seems to have been
one of general satisfaction. John Adams
considered it “A most ample, generous,
liberal provision. . . . The expense will be
great, but humanity overcame avarice.” The
pay scale was indeed high, since it gave the
senior surgeon, for example, approximately
a dollar a day more than a colonel of the
Continental Army earned. The fundamental
problem lay not with the pay scale but

Continental Army Medical Department Evolution 37

rather with the late payment of the assigned
salaries, which ran months, if not years,
late.50

Modifications and additions to the legis-
lation as originally passed began to appear
before a week had passed, partially as a
result of an apparent trend away from the
British custom which separated the func-
tion of the surgeon from that of the physician
and toward a tacit recognition of the actual
practice in the colonies. The Shippen-
Cochran plan in the form it took on 14
February 1777 mentioned both senior sur-
geons and senior physicians and although
the desirability of keeping the wounded and
the sick physically separated was reiterated,
the requirement of the 7-8 April legislation
for separate positions of Surgeon General
and Physician General was partially removed
on 12 April when Congress gave both identi-
cal duties; each should function in the ca-
pacity of Physician and Surgeon General.
The complete elimination of any distinction
between the duties of the physician and the
surgeon at all levels was not officially
achieved until September 1780.5!

On 22 April 1777, Congress issued still
further additions to the new regulations.
Concerned with providing care for military
patients as quickly as possible, the legislation
ordered that the Director and Deputy Direc-
tors publish frequently in the local news-
papers the locations of military hospitals
so that men unable to continue their march
could be sent to the one closest to them.
Officers were authorized to send patients
to the nearest private physician for care
if no military hospital were at hand, but
were required to send them as soon as pos-
sible thereafter to a military facility.52

Shippen was not formally elected Direc-
tor General until 11 April when the other
high offices of the department were also
filled, although his election was by the
unanimous vote of the states. His Surgeon
General in the Middle Department was Ben-
jamin Rush, who had first worked with the
38 THE ARMY MEDICAL DEPARTMENT,

department as a volunteer in December
1776, and others of his staff were also ex-
perienced physicians; it was hoped that the
reorganization would result in an influx of
well-trained doctors to the Hospital Depart-
ment.

The complete list of officers of the Hos-
pital Department elected on 11 April 1777
is as follows:

Director General, William Shippen, Jr.

Physician General of the hospital in the Middle
Department, Walter Jones

Surgeon General of the hospital in the Middle
Department, Benjamin Rush

Physician and Surgeon General of the army
in the Middle Department, John Cochran

Deputy Director General in the Eastern De-
partment, Isaac Foster

Physician General of the hospital in the East-
ern Department, Ammi Ruhamah Cutter

Surgeon General of the hospital in the East-
ern Department, Philip Turner

Physician and Surgeon General of the army
in the Eastern Department, William Burnet

Deputy Director General of the hospital in the
Northern Department, Jonathan Potts

Physician General of the hospital in the North-
ern Department, Malachi Treat

Surgeon General of the hospital in the North-
ern Department, Francis Forgue

Physician and Surgeon General of the army
in the Northern Department, John Bartlett

Sources: Ford, Journals of the Continental Congress, 7: 253;

Francis Bernard Heitman, Historical Register of Officers of the

Continental Army During the War of the Revolution, April 1775
to December 1783 (Washington: 1892-93).

On 5 June, in a further attempt to en-
hance the department’s image, a notice
signed by Shippen and Cochran in their
official capacities was placed in the Penn-
sylvania Evening Post, publicizing the new
appointments and stating that “all the mili-
tary hospitals of the United States are in
excellent order, and that the Army enjoy
[sic] a degree of health, seldom to be seen
or read of.” The significance of this an-
nouncement becomes apparent when it is
considered in the light of the fact that

1775-1818

Washington believed that the condition of
the Army’s hospitals had contributed to the
melting away of his entire army in the
winter of 1776-77.%3

SHIPPEN’S CONTROVERSIAL
ADMINISTRATION

Shippen, like Morgan, was trained at Edin-
burgh and London after receiving his under-
graduate degree in the colonies and serving
there as an apprentice. Although he gained
distinction as a physician who was genuine-
ly concerned for his patients, it was as a
teacher and as a social animal that he espe-
cially shone. “Nature had been uncommon-
ly bountiful in his form and aspect,” wrote a
fellow physician, ‘his manners were ex-
tremely elegant . . . he belonged to a family
proverbial for good temper . . . he was . . .
particularly agreeable to young people.” It
was said that before the enmity arose be-
tween the two Philadelphia doctors, “there
was no one who did not wish him well” and
that at his death in 1808, “he left the world
without an enemy.” 54

Shippen was immediately faced with the
problems which had haunted both Church
and Morgan. Supplies were disastrously
short, rivalries were flourishing, the depart-
ment’s organization was still far from per-
fect, and Congress was still contributing as
much to the problems as to their solutions.
It is also possible that the new Director
General himself to some degree added to the
department’s problems since, except for his
first two winters in the Army, he continued
to teach anatomy as he had before the war,
and thus did not devote his entire time to
the Hospital Department. It is also possible
that he was unwilling to endure prolonged
personal hardship and deprivation, although
the matter is open to question.5®

The number of sick, which was high even
before the campaign of 1777 began, grew
even higher as the cold weather came on.
“The extreme fatigue and hardship which
Ch. 2]

the Soldiers underwent in the course of the
Winter, added to the want of Cloath [sic],
and, I may add, Provisions, have rendered
them very sickly,” Washington believed.?¢

This same lack of food and clothing also
helped to make the sick in the hospitals
even sicker. John Adams, noting that disease
killed ten soldiers for one killed in battle,
added that “Discipline, discipline is the great
thing wanted. There can be no order nor
cleanliness in an army without disci-
pline.” 57

Supplies of almost any description were
very hard to find and the problems experi-
enced in this regard by the Hospital Depart-
ment were but a reflection of the overall
situation, although the larger budget allowed
by Congress for drugs kept the situation
from becoming in this respect as desperate
as it was in 1776.58 Food, especially
vegetables, vinegar, soap, and clothing were
particularly hard to obtain for Army pa-
tients, although in August 1777, the Conti-
nental Congress gave the Hospital Depart-
ment permission to draw upon the issuing
commissaries. Many patients otherwise
ready to rejoin their units were unable io
do so because they were literally naked.
By late October, Shippen was begging Con-
gress for clothing but it was not until 19
November that this body granted Army
hospitals a share of the Army’s clothing sup-
ply and permission to install stoves to keep
the unclothed patients warm.?®

While Washington admitted that “It is but
too melancholy a truth, that our Hospital
Stores are exceedingly scanty and deficient
in every instance, and I fear there is no
prospect of their being better shortly,” 6°
many did not understand the nature of these
shortages and blamed the sufferings of the
Army’s patients upon the Hospital Depart-
ment and its Director, as they had under
Morgan. By the end of 1777, for example,
Rush was attacking Shippen with increas-
ing vigor, citing as causes of patient wretch-
edness both the “want of checks upon the

Continental Army Medical Department Evolution 39

lower officers of the hospitals” and also
what he maintained was Shippen’s refusal
to deal with these officers and to join
him in appealing to Washington and to
Congress. Rush was certain that Shippen’s
influence among politicians could produce
action which would cure the problem. Con-
gress, in response to the spiraling costs, re-
solved in early January 1778 that every
officer hospitalized with venereal disease
should be fined ten dollars and every soldier
four, the sums so collected to be used to buy
blankets and shirts for hospital patients.%!

Congress was increasingly displeased
about the operations of the Hospital De-
partment and complained that for a lengthy
period of time it had been forced to assume
the role of Director General of the hospitals
in addition to that of the other Army de-
partment heads. Great hopes were held out,
however, for a reform plan adopted in
February 1778, partly as a result of the
urgent complaints of Rush, who showed
little awareness of the inevitable effects of
the universal shortage of supplies and sought
to solve the department’s problems by re-
organization. (See Appendix E.)

Under the new plan, the Director was
relieved of all supply responsibilities. The
new position of Deputy Director for the
Middle Department was created and Jona-
than Potts was named to fill it. Although he
was not given the title of purveyor, the
new Deputy Director would assume all pur-
veying functions. He would pay salaries and
incidental expenses and buy medicines and
supplies, distributing them with the aid of
assistant deputy directors to be specifically
assigned responsibility for such matters in
each district. Accounting procedures were
tightened. The staff which would in the
years to come assist the officer functioning
as purveyor generally included not only
clerks and storekeepers but also purchasing
agents and assistants to help with the distri-
bution of supplies. Estimates of need were
routinely sent to the purveyor, who then
40 THE ARMY MEDICAL DEPARTMENT,

turned to such agencies as might reasonably
be expected to provide the requested items.
Among these possible sources were state
agencies, the Commissary General, the
Quartermaster General, the Clothier Gen-
eral, the Continental Druggist, and the vari-
ous contractors serving the Army. When
the purveyor attempted to buy privately,
however, he was forced to bid against other
governmental representatives, a situation
which resulted in artificially inflated prices
for all. Congress through its committees
looked as far as Europe and the West
Indies for drugs which, when received,
were turned over to the Apothecary Gen-
eral by the purveyor. The new organization
was, of course, unable to keep inflation and
inadequate funding from interfering with
the department's ability to supply its
needs.

The new legislation also reduced the
responsibilities of the office of the Deputy
Director General in the Eastern and
Northern Departments, where there was lit-
tle action after Burgoyne’s defeat in the fall
of 1777. The number of hospitals in each
district, for example, would be determined
by the district’s Physician General and Sur-
geon General, who would also consult
directly with the Director General concern-
ing supply needs rather than work through
the Deputy Director. In the absence of the
Director General, these two officers would
also appoint the wardmasters of their dis-
trict. Reports from the Physician General
and the Surgeon General would no longer
be routed through their Deputy Director
but would be submitted directly to the Direc-
tor General. (See Appendix E.)

It was also in February 1778 that the
French entered the war against Great
Britain. Although this development was
crucial to the eventual winning of the war,
initially it only added to the supply prob-
lems faced by the Americans, since the
French handled their own supply and paid
higher prices than the Americans to be sure

1775-1818

of obtaining what they needed, which raised
the prices the Americans had to pay.
Following the appointment of Jonathan
Potts as Deputy Director for the Middle
Department, Congress was for a time
financially more generous to the Hospital
Department, and both morale and hospital
conditions seem to have improved. By the
fall of 1778, the clothing situation appears
to have improved as well. As time went on,
however, congressional generosity no longer
sufficed. The Treasury did not have enough
money to give the Hospital Department that
which Congress assigned to it, and increasing
inflation was severely undercutting the pur-
chasing power of such sums as the depart-
ment did receive. By the end of 1779, infla-
tion was so great that $30 in Continental
money was not worth $1 in specie, and
food was again short everywhere, although
appeals to the local populace at times pro-
duced good results. By the summer of 1780,
the department was “destitute of those neces-
saries which are indispensable for the sick,”
and suggestions were even being made that
Potts might be profiting from his position.
In attempting to defend himself, Potts ac-
curately pointed out that a number of men
including other physicians within the depart-
ment and assistant Directors General, such
as Thomas Bond and James Craik, com-
missaries, assistant commissaries, and
stewards handled purchasing at one time
or another.®® John Cochran, soon to become
the fourth Director General, had little hope
for improvement in the supply situation
and blamed Congress and its Medical Com-
mittee “who will probably pow-wow over it
awhile and nothing more be heard of it.” 4

Although the legislation of April 1777
ended the regimental medical system as a
separate entity, the enmity between regi-
mental and hospital surgeons also continued
to plague the department for a time and
their “continual jealousies and altercations”
in January 1778 “had a very pernicious
influence,” in Washington’s opinion. His
Ch. 2]

efforts to have regimental surgeons submit
regular weekly reports to the officers of the
local division of the Hospital Department
on the number and condition of their pa-
tients apparently met with limited success,
since he found it necessary to repeat them
from time to time. Eventually, however,
general distrust of regimental surgeons be-
gan to wane, and Washington himself noted
his desire to see the regimental surgeon
given more leeway, since being moved to a
general hospital could harm many patients. 5?

The confusion about the extent of the
authority of the Director General, however,
did not disappear under Shippen. Although
the April 1777 legislation placed no geo-
graphical restrictions on Shippen’s authority,
in August 1777 the Continental Congress
stated that the April reform plan was not to
be applied to the division of the Hospital
Department operating in Virginia under
Rickman and, furthermore, that Shippen
must withdraw any doctors whom he, assum-
ing that he was Rickman’s supervisor, may
have sent into the South.%

Presumably already damaged by the con-
fusion within the department, morale was
further damaged by the fact that in the
early years of the war the men of the Conti-
nental Hospital Department had neither mili-
tary rank nor the privileges of the military
officer.” They appealed to Washington in
April 1779 for permission at least to draw
clothing from Army stores, but Washington
did not have the authority to permit this.
In November 1779, after Congress passed
and then rescinded one resolution on the
matter, a clothing allowance was finally
voted, to be granted on the same basis as
it had been in 1777 to line officers. When
additional regulations governing the draw-
ing of clothing were passed for line officers
a few days later, physicians were again
omitted, and the oversight was not remedied
until September 1780. It should be noted,
however, that as late as March 1780, even
line officers were apparently not in actual

Continental Army Medical Department Evolution 41

practice receiving clothing from the Army.
The members of Congress also agreed in
November 1779 upon legislation assigning
Army physicians a monetary subsistence al-
lowance to replace the rations assigned them
in 1777 and to be based on a formula de-
rived from the pay scale of line officers, the
Director General receiving a colonel’s
share.%8

Army doctors resented, however, the
fact that they still had not been granted re-
tirement half pay for a seven-year period
as had line officers in 1778. To force Con-
gress to assign them half pay, they
threatened in December 1779 to resign en
masse the following January 1780. An
attempt to put through the desired measure
on 3 January 1780 failed of passage, but
the men of the Hospital Department did
not, despite their disappointment, desert
their patients by carrying out their threat
of mass resignations, even when line officers
were given half pay for life in October 1780.
Not until 17 January 1781 and only after
strong urging by Washington were medical
officers included under half-pay provisions
passed carlier for line officers. According to
the 1781 legislation, all medical officers ap-
pointed by Congress who remained in the
service for the entire war would receive half
pay for life, but the Director was paid as if
his rank were that of a lieutenant colonel.
Medical officers also received at this time
compensation for the effects of depreciation,
a measure they had been supporting since
1780.99

The ability of the department to function
was further diminished by stories of great
abuses within the Hospital Department,
spurred by Rush’s almost continuous criti-
cisms, which again began to carry consider-
able weight in 1779, when demands for
further reform reappeared. A request for
$1 million for the Hospital Department was
halved after violent debate on the waste
believed to characterize its operations, es-
pecially as far as food and wine were con-
42 THE ARMY MEDICAL DEPARTMENT,

cerned. Benjamin Rush, who had resigned
his commission in the Hospital Department
as a result of his quarrels with Shippen and
was by now considered to be the Director
General's bitter enemy, accused Shippen of
trading in the very hospital stores with which
Congress was most concerned, especially
wine and sugar. In June 1779, his own name
cleared, Morgan joined Rush in clamoring
that Shippen be court-martialed. Since
Washington insisted that nothing be done
until the campaign of that season was com-
plete, however, Morgan’s demands that Ship-
pen be at least suspended from office until
he could be brought to trial were in vain.”

By December 1779, preparations for the
court-martial of the Director General were
under way, but the Hospital Department
was facing further hardships. The winter of
1779-80 was unusually bitter, food was
scarce, and the deep snow hindered the
delivery of provisions. When a thaw set
in, the resulting mud made roads impassable.
By March 1780, when the case against
Shippen was ready for trial, hospital stores,
according to Cochran, were exhausted.”

Most of the accusations which were
formally placed against Shippen originated
in the period of Rush’s service in 1776 and
early 1777 when, as Shippen pointed out,
Morgan had voluntarily remained in enemy-
occupied Philadelphia.” Morgan was, there-
fore, forced to rely heavily upon Rush in
his attempts to disgrace his old enemy. Rush
was a man of obvious charm but question-
able integrity. A contemporary, Dr. Thomas
Bond, who was described by Whitfield Bell
as “one of the sanest of the Philadelphia
physicians” and at one time praised by
Rush himself,”® commented bluntly that
Rush was “capable of LYING in the
WORST SENSE of that approbrious
[sic] word” and called him “an unprin-
cipled man.”

In the spring of 1780, Morgan and Rush
were ready to present five formal charges
against their enemy. Shippen was accused of

1775-1818

fraud in selling hospital stores as his own
and moving them at government expense in
government-owned wagons, of speculation
in hospital stores and adulterating hospital
wines at Bethlehem, of keeping no regular
set of accounts for the Hospital Department,
of neglect of his hospital duties to the
point where soldiers died as a result, and
of behavior unbecoming an officer and a
gentleman in his alleged attacks upon Mor-
gan. Unfortunately, the official records of
the prolonged trial have not survived so
that only the correspondence of that period
and the newspaper evidence of the struggle
in the form of “letters to the editor” can
shed light upon the nature of the testimony
offered by both sides during the trial and
during the hearings of the Continental Con-
gress which followed it.”

The reputations of Shippen and Morgan
are still controversial. The documents of the
time, however, indicate that the major
difficulties of the Hospital Department were
not only frustrating but also inevitable and
not to be blamed upon any single man or
group of men, It seems likely, furthermore,
that neither Shippen nor anyone else could
have emerged unscathed from an attack by
Morgan and Rush once their ire had been
sufficiently aroused. Shippen appears to have
been the kind of man the ambitious Morgan
(and perhaps Rush also) wished to be and
to have won without great effort the ac-
claim Morgan was struggling so fiercely to
gain for himself. On the other hand, Ship-
pen does not seem to have been, for all
his charm and talent, capable of great self-
sacrifice. The basic conflict here appears to
have been not so much of principle as of
personality and ambition.

On 27 June 1780, the court-martial
acquitted Shippen of all the charges against
him, noting in the instance of the specula-
tion charge, however, that Shippen had in-
deed speculated in stores of the kind used
in hospitals and that this was “highly im-
proper and justly reprehensible.” The final
Ch. 2]

charge, that of conduct unbecoming an
officer, was dismissed as “groundless and
malicious.” 76

The results of the trial established that,
despite their claims, Morgan and Rush
could not find witnesses to prove the first
charge of selling stores belonging to the
hospital for his personal profit. Dr. Bond's
testimony that the third charge, of not
keeping proper accounts, was false was ap-
parently convincing. The charge of neglect
made public much conflicting testimony, pos-
sibly including letters dated 1777 from Rush
himself in which he praised Shippen’s con-
duct of the department. The trial also
raised questions as to the propriety of the
ways in which Morgan and Rush had
gathered their testimony on this charge.”

Since the court-martial had taken place
at the request of Congress, Washington
wished its verdict to have congressional ap-
proval, but he urged that it hurry its deci-
sion because of the disordered state of the
Hospital Department. After some delay in
coming to a decision, on 18 August 1780,
a month after it received the court’s verdict,
the Continental Congress resolved that “The
court martial having acquitted the said Dr.
W. Shippen, Ordered, that he be discharged
from arrest.” 78

This was by no means the end of the mat-
ter, however. Morgan, despite his earlier
firm assurances that he would abide by the
court’s decision no matter what it might be,
joined Rush in criticizing the verdict, the
court’s methods of handling the trial, the
officers conducting it, and Shippen’s wit-
nesses, using as their vehicle a newspaper,
the Pennsylvania Packet.™

Although Shippen remained as Director
General of the Hospital Department, Con-
gress still believed that reform was desirable.
The Medical Committee brought in a report
in July, and a reform resolve was finally
adopted on 30 September, to be followed on
6-7 October by the election of officers for
the newly reorganized department.8°

Continental Army Medical Department Evolution 43

The new legislation increased the role of
Congress in choosing department personnel,
who were reduced in number through a re-
organization which no longer called for a
separate staff for each geographical division.
(See Appendix F.) The posts of Deputy and
Assistant Deputy Directors General were
among those eliminated. The office of Pur-
veyor was officially created; the Purveyor
was required to render his accounts to the
Board of the Treasury rather than to the
Director General. Three chief hospital physi-
cians were responsible for the general hos-
pital system and a chief physician for each
army supervised the regimental medical
staff. The fifteen senior hospital physicians,
in addition to the highest ranking members
of the department, were all to be elected by
Congress. Any participation in trade by em-
ployees or members of the department was
forbidden, and all medical officers from sur-
geon’s mates upward were to receive allot-
ments of land upon retirement just as had
been voted line officers earlier, the Director
ranking for this particular purpose as briga-
dier general and the surgeon’s mates as
captains. The Army hospitals from North
Carolina to Georgia, however, were to con-
tinue under the old organization.

When elections were held for the newly
reorganized department, Shippen, rather
than being quietly dropped, as might have
been expected had serious credence been
given to the charges so recently placed
against him, was reelected as Director Gen-
eral. John Cochran and James Craik, both
recommended by Washington, in addition
to Malachi Treat and Charles McKnight,
received other top posts. The next day the
rest of the medical staff was selected; 82 it
was apparently determined at this time that
only one Chief Physician and Surgeon Gen-
eral for the Army was needed and the posi-
tion was given to Cochran.

Officers of the Army Hospital Depart-
ment as of 7 October 1780 were:

Director General, William Shippen, Jr.
44 THE ARMY MEDICAL DEPARTMENT,

JOHN COCHRAN. (Courtesy of National Library
of Medicine.)

Chief Physician and Surgeon General of the
Army, John Cochran

Chief Hospital Physicians and Surgeons,
James Craik, Malachi Treat, Charles Mc-
Knight

Purveyor, Thomas Bond, Jr.

Assistant Purveyor, Isaac Ledyard

Apothecary, Andrew Craigie

Assistant Apothecary, William Johonot

Hospital Physicians and Surgeons, James Til-
ton, Samuel Adams, David Townshend,
Henry Latimer, Francis Hagan, Philip Tur-
ner, William Burnet, John Warren, Moses
Scott, David Jackson, Bodo Otto, Moses
Bloomfield, William Eustis, George Draper,
Barnabas Binney.

Source: Ford. Journals of the Continental Congress, 18:908-10.

Despite repeated reorganizations, the old
problem of supply remained. In December,
the Medical Committee admitted to the Con-
tinental Congress “That on account of the
failures in obtaining money, the sick are in
a suffering condition; The Physicians unable

 

1775-1818

to proceed to their respective charges, and
the business of the Department greatly im-
peeded [sic] in every part.” Bond, as Pur-
veyor, was unable to obtain even such funds
as had been voted to him. As the winter
deepened, transportation difficulties once
more complicated the desperate supply situa-
tion and the lack of funds further hindered
attempts to obtain horses and wagons. With
conditions becoming ever more grave, on 3
January 1781, Shippen resigned, claiming
that he did so because Congress had decided
that the duties of a professor of anatomy
and those of the Director General of the
Hospital were not compatible.8?

THE HosPITAL DEPARTMENT

UNDER COCHRAN

On 11 January, John Cochran and two
others were nominated for the post of
Director General, and on the 13th, John
Morgan was added to the list of candidates.
On the 17th, Cochran was elected. The
new Director was known to his contem-
poraries as “an able and experienced prac-
titioner.” He also apparently possessed con-
siderable administrative ability, badly needed
at this time.®* He had achieved an enviable
professional reputation without the benefit
of graduation from any formal medical
school, having been entirely apprentice
trained, but had gained military experience
as a surgeon’s mate in the French and In-
dian War. Not as personally ambitious as
his predecessors, he once wrote that his “ap-
pointment was unsolicited, and a rank to
which 1 never aspired, being perfectly
happy where I was.” He openly maintained
that he preferred James Craik for the post.
He had considerable experience in the Con-
tinental Army, having been appointed As-
sistant Director of the flying camp hospital
in 1776, Surgeon General of the Middle De-
partment in 1777, and Chief Physician and
Surgeon of the Army in 1780.85

On the same day that Cochran was ap-
Ch. 2]

pointed Director General, several changes
were made in the rules governing the Hos-
pital Department. The power of the Chief
Physician and Surgeon of the Army to
remove regimental surgeons and mates for
neglect of duty was modified so that these
officers could only be suspended until they
could be court-martialed, hospital physicians
were empowered to appoint matrons, nurses,
and other lesser figures necessary to the
smooth functioning of Army hospitals, and
the half-pay provision was passed.8¢

Various other changes in the organization
of the Hospital Department followed one
upon the other throughout the last three
years of the war. In March 1781, the
Southern Department was at last brought
directly under the Director General, although
in his absence from that area, its administra-
tion was placed under its own Deputy
Director, Dr. David Oliphant. The entire
staff in the South included, in addition to
the Deputy Director, a Deputy Apothecary,
a Deputy Purveyor, a Chief Physician of
the Hospital who was required also to have
the skills of a surgeon, two hospital physi-
cians also to be qualified as surgeons, four
surgeon’s mates, one assistant each to the
Deputy Purveyor and Deputy Apothecary,
and lesser figures as necessary. Named to
these positions were men who had served
under Oliphant in the South before this
change, including Dr. Peter Fayssoux as
Chief Physician of the Hospital.8?

In May 1781, the Medical Committee
which had for so long supervised the affairs
of the Hospital Department was discontin-
ued and the department was required to
submit its returns to the Board of War. The
board was itself superseded later in the
year by the War Office under Secretary of
War Benjamin Lincoln. The following July,
a hospital board was established, consisting
of the Director General, the Chief Physi-
cian of the Army or one of the Chief Hos-
pital Physicians, and two hospital physi-
cians, with a general officer presiding who

Continental Army Medical Department Evolution 45

could exercise a tie-breaking vote as neces-
sary. This board was assigned the task of
determining the fitness of applicants for
positions applied for in the Hospital De-
partment.58

Still not satisfied with the operations of
the Hospital Department, the Continental
Congress began in the fall of 1781 to con-
sider complex proposals for yet another re-
form. Among the ideas examined was a
suggestion that a complete turnabout be
made and the use of regimental hospitals
strongly encouraged. By early January 1782,
however, the committee studying the matter
had determined that, since the war was ap-
parently near an end, such a complete
change was not appropriate and that lesser
modifications would be satisfactory. The of-
fices of the Chief Hospital Physician and of
the Chief Physician of the Army were abol-
ished and a three-man hospital board was
set up to examine all candidates for promo-
tion and to give advice.??

Under the new legislation, the Purveyor,
under whom the stewards were to serve,
was to report to the Superintendent of
Finance, Robert Morris, appointed in 1781
to bring order to the chaotic finances of the
Revolution. Further steps were also taken to
tighten accounting methods. A committee
investigating this matter recommended in
July 1782 that an invariable standard of
prices be established in the apothecary’s
office to systemize accounting. Accounting
procedures were carefully outlined in detail
so that this aspect of the department could
function in as orderly a manner as possible.
The committee also requested an immediate
inventory of all the public property held by
any medical officer. By October 1782, Mor-
ris was ready to appoint commissioners to
settle the Hospital Department’s accounts.?®

The winter of 1780-81 was a tragic one
for the Continental Army and particularly
for the Hospital Department. Shortages
were extremely severe, to the point where
some hospital physicians were unable to
46 THE ARMY MEDICAL DEPARTMENT,

make out their returns because of the short-
age of paper. Cochran wrote repeatedly to
the President of Congress, emphasizing his
belief that “‘unless some speedy and effec-
tual means are taken to relieve the sick, a
number of valuable soldiers in the American
Army will perish through want of neces-
saries.” In February. Cochran was ordered
to take over all publicly owned stores being
held in private hands and, in at least one
instance, Washington stated that, if neces-
sary, force should be used to acquire this
property. Specifically mentioned at this time
were the medicines of Dr. Isaac Foster,
former Deputy Director General in the
Eastern Department and former acting
Director after Church’s disgrace, who, main-
taining that he had not been reimbursed
for drug purchases, refused to turn over his
supply.®!

The appointment of Morris as Superin-
tendent of Finance on 29 February 1781 led
to a gradual improvement in the young
nation’s finances, which in time favorably
affected the supply problems of the Hospital
Department; in January 1781, the Army was
experiencing mutinies, and by March, the
staffs of some hospitals were reduced to
sending ambulatory patients into the sur-
rounding communities to beg for food. Even
in the summer of 1781, Army patients were
“suffering extreme distress for stores of
every kind,” physicians were being asked
to furnish their own instruments, and Bond,
as Purveyor, was being urged to turn once
again to the ladies of surrounding com-
munities to obtain old linens for dressings.

Although the decisive battle of York-
town culminated in the British surrender in
October 1781, the Continental Army was
still experiencing supply shortages well into
the summer of 1782.92 Many suppliers had
not been paid and, as a result, were reluc-
tant to continue to deal with the Continental
government. By early 1782, Bond was being
accused of using the money sent him “to
different Purposes from those which were

1775-1818

intended,” and of delaying the sending in of
his reports. Morris sharply informed the
Purveyor in February 1782 that “Until I am
possessed of these Things, I will not advance
one Shilling for the Purpose.” Bond’s de-
ficiencies as far as reports were concerned
so distressed Morris that, in June 1783, he
wrote the unfortunate physician that he
would very much regret it if he were forced
by Bond’s delinquency to request these docu-
ments “in Terms which might excite your
Painful emotions.” 98

By the fall of 1782, however, supplies and
gold were beginning to arrive from France,
by which time, of course, the need for sup-
plies was dwindling as the pace of the war
slowed.

When Cochran became Director General
of the Hospital Department in 1781, how-
ever, the personal financial situation of the
officers of the department still was neither
clear nor strong. The most immediate prob-
lem at this time was the tardy arrival of pay,
which in some instances was two years
overdue. This situation led even to resigna-
tion on the part of physicians unable to
support themselves and their families under
such circumstances. Cochran himself was at
times unable to pay his way to Philadelphia
to bring the department’s problems before
Congress. When Congress did issue warrants
for pay, inflation seriously undercut their
worth. “For God’s sake,” Cochran wrote
Robert Morris on 26 July 1781, “help us
as soon as you can. Most of our officers
have not received one shilling of pay in up-
wards of two years.” Furthermore, Cochran
noted that the French paid their military
doctors over half again as much as the
American doctors were supposed to be re-
ceiving and that even the British medical
officer was better paid than his colonial
counterpart.® Although legislation calling,
on paper, for compensation for depreciation
had been granted to medical officers, when
attempts were made to execute this law,
difficulties were encountered. The warrants
Ch. 2]

for this purpose were to be drawn on the
states, but New York refused to go along,®
and none of the states was in a position to
pay a lump sum all at once. Pennsylvania,
for example, decided to issue “Certificates of
Indebtedness” as compensation.

The problem of half pay was only partly
settled, although the original resolution on
this subject was dated January 1781. In
March 1783, a new modification was pro-
posed, permitting the officers of the Hos-
pital Department, as well as line officers, to
receive five years of full pay in money or
securities at 6 percent rather than half pay
for life, if they so voted as a group.®?

Resignations, often prompted by financial
problems, left openings within the Hospital
Department and raised the question of
standards for promotion. Men such as Dr.
James Tilton favored a general promotion
by seniority, but Cochran noted the pos-
sibility of the promotion of unqualified men
and pointed out that the British did not
promote in this manner. “It affords me
but Melancholy Prospect,” he wrote, “when
Gentlemen, who are capable and willing to
do their Duty, . . . take their departure from
us. . . . God knows, with what kind of Cat-
tle their Places will be supplied.” 98 Less than
three weeks later, Cochran pointed out in a
letter to the President of Congress that he
had several vacancies and suggested that the
most senior mates could move up. By July,
there were seven vacancies among the fifteen
positions of hospital physician. Congress
ordered that vacancies in the state lines be
filled as would any other vacancy within the
regiment and that the Director appoint men
to fill any positions vacant in the regiments
not of state lines. By August, Washington
was urging that an overall solution be de-
veloped for the problem, and Cochran was
wondering if Congress had forgotten the
wounded and sick. By September, there was
also an urgent need for physicians within
the Southern Department, but Cochran be-
lieved that these vacancies should be filled

Continental Army Medical Department Evolution 47

by southern physicians who could report
for duty at once rather than by men pro-
moted to these positions from the north.%?

On 20 September 1781, the matter finally
reached a vote and Tilton’s recommenda-
tions for promotion by seniority were adop-
ted. Senior hospital physicians from hos-
pitals recently closed were to receive first
consideration for vacancies at that level.
Hospital mates of the greatest seniority and
regimental surgeons held the next priority,
the two classifications to be equally ranked
and examinations necessary for both. Ap-
pointments to the highest positions were still
to be made by Congress, in theory on the
basis of merit alone.'°®

On 21 September, however, once again a
motion was put before Congress to com-
pletely rescind a resolution just passed the
previous day. This attempt to rescind
Tilton’s proposal failed of passage, but on
the 22d, a motion to suspend the promotion
of mates to physicians passed. On 3 Janu-
ary 1782, Congress ordered that hospital
physicians be appointed from amongst hos-
pital mates and regimental surgeons. The
latter, to qualify ahead of the former, would
have to take an examination to prove their
competence. The obvious reluctance of Con-
gress to promote physicians apparently
stemmed from the conviction that the de-
partment already had enough officers in each
rank.10!

During the summer of 1782, Washington
was in correspondence with the British gen-
eral, Sir Guy Carleton, over the matter of
granting immunity from prisoner-of-war
status to hospital officers as first proposed
by Carleton. By September 1782, Washing-
ton was able to notify his generals Heath
and Knox that Congress had, on 9 Septem-
ber, resolved that captured surgeons, hos-
pital officers, and chaplains were no longer
to be classified as prisoners of war.102

Even before the British surrender at
Yorktown in October 1781, however,
Cochran received totally unexpected orders
48 THE ARMY MEDICAL DEPARTMENT,

from the Board of War to start closing
hospitals, beginning with those at Yellow
Springs, Pennsylvania, Albany, and Boston.
He found these orders most confusing, since
the cost of closing the Boston and Albany
hospitals and transferring the patients else-
where would be great both in money and in
the danger to the patients. Some who were
interested in the problem were now raising
once again the old matter of the death
rate in general hospitals, as Cochran noted
in a letter to Craik, and were saying that
general hospitals should be eliminated en-
tirely in favor of regimental hospitals.
Cochran likened this attitude to the notion
that one should never go to bed because so
many people died there; he told the Presi-
dent of Congress that he feared that Con-
gress was not so familiar with the medical
establishment as it might be and was being
unduly swayed by the advice of those who
were seeking their own advantage. “I fear
we have some evil Counselors who are en-
deavoring to lead us astray, for astray we
are going, as fast as the devil can drive us,”
he wrote to Dr. Barnabas Binney.!%3

Cochran apparently resigned himself to
the closing of the Boston unit in the face
of the argument that it held few Continental
patients and that the state should assume
the responsibility for returning prisoners
and Massachusetts recruits. He believed,
nevertheless, that the breakup of the Boston
and Albany hospitals would be very expen-
sive. Money would be necessary to procure
accommodations for the patients who were
put out of these facilities when the nearest
hospital still open was 200 miles away.
To save a relatively small sum, the Board of
War, in Cochran’s opinion, was spending a
large sum.104

Although Cochran wrote to Dr. John
Warren in Boston in October 1781 that the
Boston hospital must be closed, he hoped to
delay the closing of the Albany hospital, es-
pecially since he had just ordered 200 more
men to be sent there. Cochran seems to

1775-1818

have had his way as far as the Albany hos-
pital was concerned, for it was still in
operation in November of 1782.105

It was almost two years after the York-
town victory that, on 3 September 1783,
the Peace of Paris was finally signed. On 18
October, Congress resolved to disband the
Army as of 3 November, and on 23 October,
the wartime Hospital Department was re-
placed by an institution to aid those “in-
valids of the army and navy” '°¢ still in
need of care.

During the most active years of the
Revolution, the Continental Army’s Hospital
Department had been crippled by confused
legislation. Its staff, often unpaid, frequently
without needed medicines and supplies, torn
by feuds, its reputation tarnished by the am-
bitions and greed of a few, struggled against
hopeless odds in the often vain attempt to
provide adequate care for the sick and
wounded. Death rates in Continental hos-
pitals in this period were high and condi-
tions in them, particularly at those times
when the Army was suffering its greatest
reverses, were often horrible. The most
vocal critics of these institutions, however,
were physicians whose comments were their
weapons in their bitter feuds. It should be
noted, furthermore, that even the civilian
facilities of Europe, which in some instances
were housed in magnificent buildings de-
signed specifically to serve as hospitals,
might shock those who visited them; the
Paris Hotel Dieu, for example, with its
four to six patients in a bed, its stench-
filled rooms, and its appalling death rate,
which at times reached a reported 33 per-
cent, was notorious.!®” In the eighteenth
century, hospitals established on an emer-
gency basis in hastily procured buildings
and filled to overflowing with patients from
a lice-infested, starving, wretched, and re-
treating army could not be expected to
exhibit conditions which were other than
frightful.

Only in the closing years of the Revolu-
Ch. 2]

tion did the picture brighten, when the chain
of command was clarified, the most conten-
tious physicians were no longer with the
department, and money and supplies began
to come in from France just as the lack of
major engagements began to reduce the pa-
tient load. It was at this point in the war

Continental Army Medical Department Evolution

49

that the officers of the American Army’s
first Medical Department began to receive
recognition of their devotion to duty when
the Congress granted them the same pen-
sions, allowances, and other considerations
which had already been awarded to officers
of the line.
From Siege to Retreat, 1775 to May 1777

The months between 27 July 1775, when
the Hospital Department was established,
and the late spring of 1777, when General
Washington’s army left its winter camp at
Morristown, New Jersey, to begin another
campaign, saw the scope of Continental
Army operations broaden from a largely in-
active siege of Boston to action on two
fronts, along the Canadian border and in the
general vicinity of New York City and north-
ern New Jersey. It was a time of limited suc-
cesses for the new army and of increasing
strain upon the Hospital Department.

THE BOSTON AREA,
1775 T1T0 1776

The 17,000-man New England army, com-
posed for the most part of Massachusetts
units, which was positioned outside of
British-occupied Boston in July 1775, was
both disorganized and undisciplined. En-
listed men generally ignored both camp and
personal hygiene and regarded attempts
to discipline them as tyranny, but when
General Washington assumed command,
only 9.5 to 12.5 percent of them were

 

BOSTON AREA

 

 

o Watertown

 

 

1775-1776
0 2
MILES
Prospect Hill
Ns
7 /\ ~
Cambridge

Brookline

 
 
 
 
 
   
      
   
  
     
    

Dorchester Height

   

Roxbury
@]

 

MAP 1
Ch. 3]

unfit for duty. Except for makeshift regi-
mental facilities, the only hospitals available
were those managed by Massachusetts at
Cambridge, Roxbury, and Watertown.
(Map 1) These hospitals seem to have
made no attempt to segregate those with
contagious diseases from the wounded, visi-
tors were allowed unlimited access to pa-
tients, and the most elementary rules of hos-
pital discipline were ignored.

During his short time as Director General,
however, Benjamin Church managed to in-
still some order into the medical service of
Washington’s army. By the late summer he
had divided the Hospital Department’s pa-
tients among six buildings, 200 in houses
named after Generals Washington, Lee,
and Putnam and served by surgeons Isaac
Foster, John Warren, Samuel Adams, Jr.,
and Charles McKnight in Cambridge, and
170 in three others serving the Roxbury

 

JOHN WARREN. (Courtesy of National Library
of Medicine.)

Siege to Retreat: 1775-May 1777 51

 

CHARLES MCKNIGHT. (Courtesy of National
Library of Medicine.)

camp but actually located, according to
Church, in Brookline. The care of Roxbury
patients was supervised by William Aspin-
wall, Lemuel Hayward, and Elisha Perkins,
all three in the pay of individual colonies
rather than that of the Hospital Depart-
ment. Church, however, urged that three
more surgeons be appointed to serve with
the department.? In December, John Morgan
referred to Aspinwall and Hayward as “ad-
ditional surgeons,” so apparently they were
by then members of the department staff.
However, no records exist giving exact in-
formation on this point. Church also planned
in August to acquire more beds so that
he could expand the Cambridge hospital to
a 240-bed capacity.?

Church had noted that his patients were
returning to duty before fully regaining
their strength and that, as a result, as many
as four of five relapsed and had to return
to the hospital. He urged the creation of
a unit specifically for convalescents where,
 

 

52 THE ARMY MEDICAL DEPARTMENT, 1775-1818
TABLE 2—HO0SPITAL DEPARTMENT UNITS IN THE BOSTON AREA WITH THE STATUS OF PATIENTS
DURING WEEK PRECEDING 2 DECEMBER 1775
Absent
Admitted | Dismissed |Discharged|{To Con- Absent |Without
Hospital Since Last Fit for | From the |valescent With Per- Dead Remaining
Return Service Army Hospital | Permission | mission
Total 128 95 5 51 1 6 13 577
At Cambridge:
Washington House 25 8 0 15 0 1 2 69
Lee House 13 10 0 0 0 1 2 65
Putnam House 12 5 0 12 0 0 2 47
Convalescent House 26 30 2 0 0 4 0 80
At Roxbury:
Ward House 18 0 1 19 0 0 5 39
Thomas House 14 17 0 5 0 0 2 50
Spencer House 20 25 2 0 1 0 0 37
(convalescents) | |

 

 

 

 

SOURCE :

John Morgan, Return of the Sick & Wounded in the General Hospital at

 

 

 

 

 

 

Cambridge & Roxbury,

25 Nov 1775-2 Dec 1775, RG 93, M246 roll 135, folder 3-1, item 15

« Morgan's addition.
if a Hospital Department physician were to
check on them each day, such patients would
otherwise need merely the care of one or
two mates. By the end of October 1775,
a convalescent hospital was in operation in
Cambridge, and by late November, it was
apparently caring for as many as seventy
to eighty patients at a time.*

On Church’s recommendation, General
Washington took action designed to im-
prove hospital discipline. On 21 August,
he assigned a guard consisting of a sergeant,
a corporal, and nine men to one of the
hospital buildings. The following day, com-
menting that Church had informed him that
patients were suffering as a result of “hav-
ing improper things carried to them to eat”
and that many of the illnesses afflicting them
might have been brought in by visitors, the
general ordered that no enlisted man or
noncommissioned officer be allowed to enter
a hospital without written permission from
either his commanding officer or a surgeon.
A week later, the general decided to or-
ganize the separate guards being set up at
individual hospitals into one guard, to con-
sist of “one Sub three Sergeants one fife
Three Corporals & Thirty men,” taking
their orders from Church.®

Despite Church’s efforts, when John
Morgan became Director General, much
was yet to be accomplished if the Hospital

Department were to care for the sick and
wounded of General Washington's army
efficiently. Since his first inspection revealed
that no one could tell him the number of
patients for whom the department was re-
sponsible, Morgan ordered that weekly re-
ports, or returns, be made to him by each
hospital unit. It is from these that we learn
the details of the structure of the depart-
ment as it existed under Morgan in the
Boston area.

Four hospital units were in Cambridge
as of 2 December 1775, when the first
return was made, the three named during
Church’s administration after the three gen-
erals plus the newer Convalescent House.
The return from Washington House was
signed by surgeon John Warren. Doctors
Samuel Adams, Jr., and James McHenry,
the latter apparently a regimental surgeon
at this time, signed the return from Lee
House, where five wards were named after
patriots Henry, Franklin, Gadsden, Rod-
ney, and Gates. Charles McKnight signed
the report from Putnam House, where six
wards were named after famous physicians,
Pringle, Monro, Black, Shippen, Cullen,
and Hunter. Surgeon’s mate Daniel Scott
signed the return from the Convalescent
House. Cambridge patients ranged in age
from 16 to 60 and the most frequent diag-
nosis was “fever.” There were also three
Ch. 3]

Siege to Retreat: 1775-May 1777

53

TABLE 3—HO0SPITAL DEPARTMENT UNITS IN THE BOSTON AREA WITH THE STATUS OF PATIENTS
DURING WEEK PRECEDING 16 DECEMBER 1775

 

 

 

 

 

 

 

 

 

 

 

Admitted | Dismissed |Discharged|/To Con- | Absent Sent,
Hospital Since Last Fit for | From the [valescent With Per- Dead Remain-
Return Service Army Hospital | Permission] mission ing
Total * 155 117 5 29 I 4 11 341
At Cambridge:
Washington House 23 11 1 7 0 0 0 73
Lee House 22 0 0 10 0 0 3 62
Putnam House 21 8 2 6 0 2 3 52
Convalescent House 29 25 2 0 1 2 0 67
At Roxbury:
Ward House 11 29 0 2 0 0 2 15
Thomas House 16 19 0 4 0 0 3 49
Spencer House
(convalescents) 23 25 0 0 0 0 0 23
SOURCE :

John Morgan, Return of the Sick & Wounded in the General Hospital at Cambridge & Roxbury,

9-16 Dec 1775, RG 93, M246, roll 135, folder 3-1, item 16

a Morgan's addition.
units at Roxbury, Thomas and Ward Houses
and the convalescent hospital, Spencer
House. Since the Roxbury returns were not
signed, the surgeons or mates in charge
there remain anonymous.®

The Director General's report to General
Washington of this same date was typical
in its form and its casual arithmetic of the
many which Morgan was to submit from the
Boston area in the following months. (Ta-
ble 2) His patients during these first weeks
did not total the 676 he claimed, although
this figure has been uncritically repeated by
subsequent historians.” In reaching his over-
all total in this instance, Morgan apparent-
ly added together the totals from all of
the individual columns, thus counting both
convalescents and newly admitted patients
twice. A more accurate figure would ap-
pear to be 497. In his report of 16 De-
cember 1775, as an example of his arith-
metic, Morgan not only incorrectly totaled
the number of admissions to Hospital De-
partment units (ten too many) but also
concluded that the department cared for
512 patients, a figure at which it is difficult
to arrive using Morgan’s figures. (Table
3) It is interesting to note that, while these
early returns were entirely handwritten, be-
ginning with that of 2 March 1776, Morgan
used preprinted forms into which the ap-
propriate entries were made.®

The health of the army besieging Boston
when Morgan became Director General
was considered by contemporaries to have
been unusually good, although the number
of men unfit for duty after General Wash-
ington took command apparently ran
from less than 14 percent to approximately
17 percent per month, if one can trust
monthly strength reports. The number of
patients actually in Hospital Department
units varied from 320 to 550 in the period
16 December 1776 to 30 March 1777
and the death rate from 1.4 percent of
these patients to 4 percent." (Table 4)
The most greatly feared threat to the
health of the army came from within the
city of Boston, where for months smallpox

-raged.

TABLE 4—MORTALITY, 16 DECEMBER 1775-
30 MARCH 1776

 

 

 

 

 

Total

Date Patients Dead
16-24 Dec 1775 439 8
23-30 Dec 465 9
30 Dec—6 Jan 1776 442 18
13-20 Jan 419 7
26 Jan-3 Feb 504 12
3-10 Feb 497 13
17-24 Feb 520 16
24 Feb-2 Mar 550 11
2-9 Mar 485 7
11-17 Mar 404 6
23-30 Mar 320 6
SOURCE: Returns of the Sick & Wounded in the General

Hospital at Cambridge & Roxbury, 16 Dec 1775-30 Mar
1776, RG 93, M246, roll 135, folder 3-1, items 17-27.
54

7

THE ARMY MEDICAL DEPARTMENT,

RE T URN of the fick and Wounded in the General Holpisal.
Houle, from Aes.. bo fe 26% 4... ho Bo. DE “prs.

1775-1818

 

 

 

 

 

 

 
   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

isle Bets y >.
Time of Adil, Rank. | Names. Axe “Regimen | _Company. | Sire Since, “Even i
Quetiony (rnd. 7 3
17s - —— hilly
Burin. B\slieah Nomar ily | 2 POTHIER moe tl 7
FAIRY Vo Mostly Np | Fahorih | Blo, Ad ] |
Tin tn Nilo? No |tts (Ll tie in lew =
22 80 Lt. A 22 NaF puenie dtondtion PM curmslionn| P22 ta
78 80 Loins og WW. Akins Fttin Wild bite
2 on y Ln Crinet 25 threeh is | Sbnheriy APP Sores Norge... ;
2 4a Chand LU ZF Ehren ts J 0th lows Bors Y ngindtle Po lon Soni SP
29% AN frvias Ginds AT Ahh Copurn LL. rr 1 Lt
a" Livni \thatioom Frnt 3D | St: He Hse Ladle oh A :
GH Fouts ere 2 Lome 2 Lrpoents L ht Sr VR . %
HN 4 Pobre Tuts VY Bint Hd, Liddy Si
at tent A Ton de {90 Vt apn Pt bot. | Lite
25° |S Honoh. sho Kour brun | % epi io
2A hint Bovist Bp a5 | bH Kt "
/ eer - i per refi eens esr eee sens
Mme. find Yes.
2 2p Jalen ii Toller Lf 4 Co ln:
Shei Bren |g |B NL
ren Holts | I | Tlrgoaen ra Het dll 56
Ph 2 ee re hi
Nebr imu? 4 37. | se »
6 and Moulliy 4 | sa Ps ; wl a
NE ot Hatrene. | 0. | SE oz - ig .
! fits Aig 117, HH on Tes | Bite
A Dodd 11 on {a Lott \ #0: |
ons Ercg :
Sid Aon? 7 2a | Grant Let Lo Bie
47 17 ’ / .
Mgppensll rd Ve
2. id a A X 5 2 A
 Lomussl Garam b/ Chunks Lphnr " sehen | A
ont Shite 20 \ bt Ll | Priinyt| Sle Plt hod
Likes Eur | |S Ign CE
Boilie NW AGE ewan | Brelite Vt. | 2. am gt
y fads Aarne 2 rnd 7 Pra.
Hore Shufhyde Ghrnoh a99 Cerys | T000,  - is
Arp A Wage
ees ght z Loreen Higbee Ad Ltt. ¢
oF | Sd Li \
he oo. 13 Godley opine Copptie )
frre " id
4 Soests le Mo: Gam, i ;
2 yeh by a - 2 ¥
Zr med fc tht - it
il oc 2 iain =
Hr.
iy,

-~ 4 7
[x a Goce Gent

RETURN SIGNED BY CHARLES MCKNIGHT. (Courtesy of National Archives.)

st

yor
Ch. 3]

Siege to Retreat: 1775-May 1777

40

55

RETURN of the Sick and Wounded in the Cenesal Hopital,

bereral Hiltons 'c Houle, from Somnde the 26%0 Busrber 2 2%) x8 :

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

vB Er Rank. | Names. | Age] Regiment | Company. T Uiforder. | Sate, Foca
7 F ’ /)
Vokes Wirrd J: 1.
es
dill” W Loiatr | Noblanil Lod [95 yo Phookiy | tttoa on td
Tonks Hip ta NUo Bp |S Gly Not | om bli Ret
oh re PAE Loo Gln’ falaty buhali | Lth
Ir futrgenmt. 3 S 2 nts ie ponies
Als WO ns LL ir ‘ A Ct gto: 30
7 le 2how: oAlls on 25 \ Lluis pa ; Por Gold % ve A
re Hrnns Hormel 2y Lomas | Glare Roig, Ai
urn Hoagaadt 35 | Lt Lutte Ms belt | Lia
; a oe Fi Neh |Full ie
gal. Bn 22 |.2- ait 2a
Lire Sry A | Hteheocki | Ln Ax fhe at
Prburt Nour ll Y | Gla ort Hany : TR
/ id y ’ tL a
wiry iar A:2.
—— : 4
: Moton 5 Sato Lorri! Pen 12» Fa ot 2 gl
: _ Alan ¢ ok iE WE La !
a I Tonle tebe H. | com ¥ AGA lore Puts fe i
alee | ru Zoke w lee Nan, |i /
ssi (Atami | 28 | fii. zw? Ja, (ae -
> Ch Henry late 7 ra Loran | Putin Pe
2 Tl or his AZ| Sng Ts = £.. ii ET
I hod Ak 2 Ghtds U8 Shin “elt 2 tom) -
4 7 su Leia a0 fone pf 4
Bk ANB Tene |Poitc  \Mofy bryuprine
4 AH, A 77 /1 13
Nach firrd LF,
A
. * St : ¥ . 23 . - i 7]
C Mode Sits Nawiit ballon \ MN Lorber. |Srker, T 4 4 Gp Git
2s Glin Tohiunw | 29 \Chonih se | hr WM It
: x Te i < 2. Loli ts , i
T hr odd forse. . Bn olountiss Lv Vedonn % - ;
Adi’ Nauti 2 Ni. oi) [ots pdr ln
"ta She util 77 lowe ta tu Nh pn’
Te lau Cte lan 20 (tiarnis  Jtbammey (Plena St fa : /
psa Lr Asko 322 gies | Att ro ks -
& tn | Later gr (ke PCR
f 8 Waly 5 2 ont CETL deg ee id 2*
28% rt C4 Ala Zonk 5 # 5
La Fa Fr tt WU |Guidly: | Gant 2p
v
2
; ” nora
56 THE ARMY MEDICAL DEPARTMENT,

In the fall and winter of 1775-76,
rumors abounded that the British were
deliberately attempting to infect their ene-
mies by sending diseased or recently
inoculated civilians out of the city. The
records on the hospitalizing of the Army’s
smallpox victims during this entire period
are incomplete, but a smallpox hospital
had been in operation, under the super-
vision of Dr. Isaac Rand, since 27 June
1775. Rand was among those caring for
patients in the Cambridge hospital under
Church, but at some time thereafter the
threat posed by smallpox waned and Gener-
al Washington decided to close the hospital.
In December 1775, however, Morgan noting
that smallpox had appeared “several times
in the army,” requested that the care of
its victims once again be assigned exclu-
sively to Rand and his mate.'® The first
mention of a smallpox hospital as reestab-
lished under Morgan appears in the Direc-
tor General's report of 20 January 1776.
At this time, five patients were listed as
“remaining” in the Cambridge institution,
implying that it had gone into operation
before that date. From the returns that fol-
lowed through the end of March 1776,
it would seem not only that smallpox was
a minor problem for Washington’s army
at this time but also that mass inoculation
of soldiers was not being undertaken, since
the greatest number listed as “remaining”
at any one time was twelve and the weekly
admission never exceeded six. James
Thacher, a regimental surgeon at this time,
recorded that the most prevalent diseases
were actually autumnal fevers and dysen-
terylike conditions.!!

Nevertheless, the threat of smallpox con-
tinued to hang over the Boston area in the
early months of 1776, and a Boston pub-
lisher even reissued Baron Dimsdale’s pam-
phlet on inoculation, for which Morgan
wrote a preface. It has been argued that
the presence of smallpox in the city of Bos-
ton was actually to some degree responsi-

1775-1818

ble for Washington's reliance upon siege
rather than attack on the British during the
fall and winter. When the enemy evacuated
Boston on 17 March 1776, Washington,
still wary, initially forbade any of his men
to enter the city except for 1,000 men who
had already had the disease, under the com-
mand of General Putnam. Both hospital
and regimental surgeons were ordered to
keep a sharp watch for smallpox victims
and to send them at once to the isolation
hospital. Apparently the contagion was still
feared weeks after the British evacuation,
for Thacher noted in May that he had be-
lieved it wise to undergo inoculation him-
self and in July that all soldiers in Boston
were to be inoculated.?

During the siege, Morgan met the sup-
ply shortage affecting the hospitals in the
Boston area by buying what he could him-
self and also by launching a vigorous cam-
paign to have both individual citizens and
states donate needed items. In Morgan’s
behalf, Washington appealed to the govern-
ments of Massachusetts, New Hampshire,
Connecticut, and Rhode Island, and with-
in a month blankets and materials for
bandages were arriving at Cambridge.
Morgan then set everyone, including sur-
geons, to work making bandages.

One of Morgan's first tasks after the
British evacuation of Boston was to locate
drugs and supplies for the new hospital in
New York. In Boston he found that medi-
cines were often held by Tories who hid
what they had or by owners who, in fear
of inflation, insisted on cash payments. In
time, a good source of medicines also proved
to be prize ships, taken from the British.
The drugs left behind by the British in Bos-
ton, however, were the source of much
controversy because of reports that they
had been poisoned. Dr. John Warren testi-
fied that on 29 March 1776, when he en-
tered the workhouse which the British had
used as a hospital, he found the medicines
in great disorder with small amounts of
Ch. 3] Siege to Retreat
yellow and white arsenic mixed in with
them. After learning that another physician
had already removed twelve to fourteen
pounds of this poison from among the
drugs, Warren recommended that no attempt
be made to use them. On Washington’s
orders and after offering to pay for what
he took, Morgan did confiscate the drug
supplies of two Tory physicians in Boston,
one of whom was reputed to have the larg-
est pharmaceutical business in the city.!?

By June, having taken over a large quan-
tity of abandoned British property and
using every other means available to him,
Morgan had acquired a large collection of
bedding, medicines, furniture, and other
supplies which, with the exception of the
materials needed for medicine chests for
five regiments left to defend Boston, he
then had moved to Connecticut, as ordered
by Washington. He was quite optimistic
about the adequacy of his stock for the
coming year, believing that he could easily
obtain the little he still needed in Phila-
delphia. His optimism, however, was not
entirely justified, since as early as April
one of his principal suppliers was running
low in items needed for regimental chests
and by May was out of bark, ipecac, and
cream of tartar, among other popular
items.1*

In anticipation of the active campaign
against Boston, which the formation of new
army units in March had made possible,
Morgan also prepared a barracks at Pros-
pect Hill which could care for at least 100
wounded. The fortification of Dorchester
Heights by the Americans made the British
position untenable, however, and they
evacuated Boston. American losses in action,
therefore, were slight, and Morgan’s plan-
ning remained essentially untested.!®

Almost immediately after the British
left Boston, the Continental Army moved
south to the defense of New York City,
leaving Morgan with the dual problems of
caring for the approximately three hundred

: 1775-May 1777 57

patients left behind in the Boston area
and of preparing to establish a new hospital
system. Maj. Gen. Charles Lee, sent in
January 1776 to prepare the defense of
New York, had written Washington as
early as 9 February to request the estab-
lishment of a hospital there, but it was
not until 3 April that Morgan received
official orders to do so. He was at that time
told to leave behind in Boston only those
surgeons and attendants necessary for the
care of soldiers too ill to move with the
army. Morgan placed Isaac Foster in charge
of these patients, who did so well that the
death rate among them was very low and
by 22 April only eighty remained in de-
partment hands. Within six weeks of re-
ceiving orders to move the department’s
main operations from Boston, he discharged
the last man and settled all his accounts
for the Boston hospitals.®

THE NORTHERN
DEPARTMENT

In the Northern Department in the late
summer and early fall of 1775, prepara-
tions were under way for an attack on
Canada under the command of Maj. Gen.
Philip Schuyler. (Map 2) These prepara-
tions left much to be desired. No depart-
ment physicians were assigned to the ex-
pedition and some units even failed to
bring regimental surgeons. Furthermore,
General Schuyler still had no hospital sup-
plies by the first week of August, when
100 of his 500 men were ill. On 6 August,
he reported this situation to the Continental
Congress, stating that he had already given
up his own personal wine supply for the
sick of his regiments and that he must have
medical supplies even if he had to pay for
them himself. He added that he had hired
a surgeon from Albany on his own authori-
ty and that he would also meet this expense
personally if Congress failed to act.”

Samuel Stringer, the physician appointed
by General Schuyler, was requested to
58

THE ARMY MEDICAL DEPARTMENT,

1775-1818

 

THE NORTHERN DEPARTMENT
1775-1777

 

MILES

 

   
   
   

St. Johns
O

Champlain

Burlington

VERMONT

(disputed claims)

/ MASSACHUSETTS
{

[TT

| Hartford
O

 

MAP 2

| aatec

CANADA

  
   
  
   

NEW
HAMPSHIRE

/
Concord LN
o \

—_——,—,—
—_—

|
| connecticut | Rt

/

7

J
(
/
’
/

\ ho
1 MAINE

(part of Mass.)

 

|
|

   
    

pe

\ Providence
Ch. 3]

bring with him as many of the supplies he
believed to be needed for Schuyler’s army
as time permitted him to gather. By 14
September, however, when Congress
officially approved both Stringer’s appoint-
ment and his reimbursement for the medi-
cines he brought with him, General
Schuyler had become too ill to continue in
command and had been replaced by Brig.
Gen. Richard Montgomery.18

Stringer’s headquarters and that of Mont-
gomery’s 2,000-man army appear to have
been at Fort George, at the southern end
of Lake George. Stringer’s only assistance
here seems to have come from regimental
surgeons and mates, but on 25 October,
he requested the assignment of Hospital
Department surgeons to serve under him.
Stringer apparently accompanied the army
only to Fort George, but General Mont-
gomery continued to Montreal, taking the
city on 12 November. By this date, how-
ever, disease, desertions, and expiring en-
listments had reduced his army to 500 men.
When he marched from Montreal to Que-
bec in December, 300 of the Montreal
army went with him and they carried with
them the seeds of a devastating epidemic
of smallpox.

While General Montgomery’s army moved
on Montreal, Col. Benedict Arnold led
approximately eleven hundred men on a
second operation against Canada, aimed at
the city of Quebec. The only medical at-
tendants to accompany him on the grueling
march through thick New England forests
and swamps were the 22-year-old regi-
mental surgeon Isaac Senter and his as-
sistants. Senter organized the hospital used
for the Continental troops before Quebec,
but although this institution was called the
“General Hospital,” it received its name
from the fact that the building housing it
already bore that designation. While most
of the Northern Army was at Quebec, the
smallpox epidemic first struck. It continued
through the spring and summer of 1776

Siege to Retreat: 1775-May 1777 59

and eventually involved not only the regi-
mental surgeons and mates but also
Stringer and the Hospital Department.®

By the spring of 1776, Brig. Gen. David
Wooster was in overall command of the
troops in Canada, General Montgomery
having been killed in action in January,
and almost half of the approximately
1,900 men before Quebec were sick. An
abortive attempt was made to start an offi-
cial inoculation program, since many offi-
cers and men were secretly inoculating
themselves and were thus intensifying the
epidemic. When British reinforcements ar-
rived at Quebec and the colonial army
fell back on Sorel, many smallpox victims
left their beds to join the flight. The epi-
demic worsened at Sorel and the men in
the Montreal area were in no better condi-
tion, 1,200 of the approximately 3,200
there in early May being unfit for duty,
according to General Arnold, most of them
sick with smallpox.2°

The Hospital Department was by no
means prepared to deal with the rapidly
growing epidemic. Stringer wrote from St.
Johns, where the army from Quebec re-
treated when it left Sorel, that he had
neither medicines nor instruments and no
way of obtaining either. It was in late May,
however, that he finally received permis-
sion to hire a larger staff.2!

A committee of the Continental Con-
gress urged in early May, when new units
were arriving and the total number of men
in Canada was approaching 8,000, that
Dr. Jonathan Potts be hired by the Hos-
pital Department for assignment to either
Canada or Fort George. By the end of May
1776, the situation of patients in the
Northern Department was “almost Suffi-
cient to excite the pity of Brutes, Large
barns [being] filled with men at the very
heighth [sic] of smallpox and not the
least things, to make them comfortable” 22
“and medicines being needed at both Fort
George and Ticonderoga.” 23
60 THE ARMY MEDICAL DEPARTMENT,

By 6 June, as estimated by the recently
created Brigadier General Arnold, who was
now in command at Montreal, only 5,000 of
the men in Canada were fit for duty. Small-
pox threatened the destruction of the entire
army. On 15 June, General Arnold evacu-
ated Montreal and by the time he arrived
at St. Johns, two days later, half of his
army was sick and the condition of all his
men so poor that to remain at St. Johns
seemed unwise. Maj. Gen. John Thomas,
who took command of the army at Quebec
on 1 May, himself died of smallpox on 2
June. “The smallpox,” mourned John
Adams, “is ten times more terrible than
Britons, Canadians and Indians, together.” 24

The misery of the men who had so recent-
ly set off to conquer Canada was total. One
hospital was described, for example, as a
“dirty, stinking place” in a camp which
“echoed with execrations upon the muske-
toes.” “Language cannot describe nor
imagination paint, the scenes of misery and
distress the Soldiery endure,” and the pa-
tients crowded into the barn which served
as the hospital were in such condition that
many “could not See, Speak, or walk. In
one day two had large maggots, an inch long,
Crawl out of their ears.”

It was only in June, however, that the
Continental Congress, while leaving Potts’s
exact status unclear, officially ordered him
to go as Physician and Surgeon to the
North. Washington was at first undecided
as to whether to send Potts or Stringer to
aid Arnold’s men who were then still in
Canada, but by 26 June, when Potts and a
supply of medicines from the Hospital De-
partment headed north with Brig. Gen.
Horatio Gates, who was to assume com-
mand of the Northern Army in the field
from Brig. Gen. John Sullivan, General
Thomas’s successor, General Arnold had
left Canada. When Potts arrived at Fort
George, he found approximately one thou-
sand patients suffering from smallpox, dys-
entery, and fevers, cared for by four sur-

1775-1818

geons and four mates. The number of pa-
tients there was still growing when the bulk
of the Northern Army, which had been first
reunited at Crown Point, fell back further
in early July to Ticonderoga. Their seriously
ill were rowed in small boats to the Hos-
pital Department’s Fort George facilities.2®

By mid-July, an estimated three thousand
of the men of the Northern Army were sick,
for the most part with smallpox, three
thousand well, and five thousand unac-
counted for. Stringer, now also at the Fort
George hospital, was close to desperation.
More units were being sent to join the
Northern Army, yet except for those which
Potts brought with him, there were no
drugs and the hospital was “in the utmost
distress for both assistants and medi-
cines.” 27 Stringer had even been reduced
to suggesting to Potts that “hemlock tops”
be used for bedding. His request to Wash-
ington of 10 May 1776 for help had not
been granted, the number of patients for
whom he was responsible was still rising,
and men were dying for lack of aid. On 26
July, the hospital at Fort George, report-
ing for a two-week period, noted 1,497
admissions, 439 discharges, and 51
deaths,?® with the deaths in a five-week
period estimated by one regimental surgeon
at 300 or more. “In the name of God,”
Stringer asked Gates, “What shall we do
with them all, my dear General?” 2

Morgan, meanwhile, noted in a letter to
Samuel Adams that he was lacking instruc-
tions as to how he should help Potts. He
had, nevertheless, appointed Dr. James Mc-
Henry to serve under Potts, instructing him
to go first to Philadelphia to obtain medi-
cines with which to resupply the hospitals
of the Northern Department. He had also
assigned Potts the assistance of an apoth-
ecary, Dr. Andrew Craigie. Morgan
ordered Potts to supply medicines both to
the department’s unit and to regimental
surgeons and to require an accounting from
regimental surgeons for whatever they used.
Ch. 3] Siege to Retreat: 1775-May 1777

oF
63 Yrrew ff J. Th of fe fomenal Shohitat I

Seeger from He 2" AK 2870, A

Agimeie — FED

 

 

 

 

 

 

 

 

 

 

 

 

 

Lp: Silene . . . . ......pol|6] pl. lag
Benes . | hy] 0] glo
Bp i. hi heiiige ler alii) ge

HH “Tp me ni n=l AE oy). - {0%
Cot: Ce Bone - = + pp mgt 9%
TR i verlag] 5.l. [a
Dactionlts - vr = ried San Sg fig) on log
“oitie, . . I 29] 3 aA Ay
Zone Tome shee ol Crime nl Sg SRL -|2®
be At ige ds ream stg last af 24
Bh . rier dre lia

Afr 4
; Fl tin mei wore t Le
Dot: Danvehaceds . . dei domes el os’
Wynhogpo el a. % 3 . [ ay
Aagrco - - “tart de dE

lun Clyhew - mi borin 4 sd 3
IC ey ol ral £. lg
Foci wm = 21. ZY

py “lin SC i i.

ee dR) 3s ih be
147) 429 573 ees
Ans for Naroew |. J mb
a Vl 1770

 

=)
1.

—

4

:

0

3

 

 

Received R "0,
from Rotur:, eq vo, Dev
Now, 34-1804 Mo da; Long
Vv, 4
R P.O 401810, 48:7

A

61

RETURN OF THE SICK OF THE HOSPITAL AT FORT GEORGE. (Courtesy of National Archives.)
62 THE ARMY MEDICAL DEPARTMENT,

 

JAMES MCcHENRY. (Courtesy of Neational Li-
brary of Medicine.)

He was to report to Morgan monthly on the
hospitals under him and their expenses.®”
McHenry had not arrived by the end
of July and the drug shortage was so severe
that Stringer received permission from
General Gates to go to New York himself
to obtain medicines. Unable to fill his re-
quirements in New York, however, Stringer
hurried to intercept McHenry, who was
preparing to travel north with the few
drugs he had been able to collect. Although
he obviously and desperately needed a
larger staff, Stringer attempted to show his
own independence by dismissing McHenry
as soon as he encountered him, in so doing
apparently failing to take over the drugs
McHenry had with him. In August, how-
ever, Potts was still in ignorance of this
development and anxiously awaiting the
arrival of his new assistant with his sup-
ply of medicines. His own dismissal of Mc-
Henry did not keep Stringer from eventu-
ally blaming Morgan for the shortage of

1775-1818

supplies in the Northern Department, be-
cause the Director General had failed to
forward the medicines which McHenry
had obtained. “A tissue of misunderstand-
ing and mistakes seem to be the fate of
your district,” McHenry commented to
Potts.3!

By the second week in August, although
he still believed he should have been inde-
pendent of Stringer, Potts had resigned
himself to working as Stringer’s subordi-
nate and acted as Director while Stringer
was absent from his post, still ostensibly
seeking drugs. There had been no enlarge-
ment of the staff caring for the patients at
Fort George and the situation at the hos-
pital had not otherwise improved since his
arrival a month earlier. Patients were
“without clothing, without bedding, or a
shelter sufficient to screen them from the
weather.” There were no jalap, bark, salts,
or opium available and the number of
sick was, according to Stringer, still in-
creasing.3?

Although the urgent need to improve
the care given patients in the Northern De-
partment was recognized by the Conti-
nental Congress by the late summer of
1776, there were occasional optimistic re-
ports in mid-August and the smallpox
threat was diminishing. Samuel Adams be-
lieved that the number of patients was no
longer increasing at Fort George, Stringer
maintained - that he had located a supply
of medicines and sent a portion of them to
Potts, and, on 28 August, General Gates
was able to write Washington that “the
Smallpox is now perfectly removed from
the Army.” For the disappearance of this
disease, Potts should receive some credit,
since he apparently did go forward with
the inoculation not long after his arrival,
as ordered by Stringer, although exact
figures are not available.33

Nevertheless, despite these hopeful
comments, the shortage of medicines was
by no means relieved, self-inoculation by
Ch. 3]

newly arriving militia was threatening a
renewed epidemic, and Stringer was still
absent from his post. When he had not
returned by 22 August, General Gates be-
came angry that the Director of his de-
partment’s hospitals would go “preferment
hunting . . . while the troops here are
suffering inexpressible distress for want of
Medicine.” Begging that medicines be sent
to Potts at Fort George, Gates added a
request that General Washington be in-
formed of Stringer’s behavior. He followed
this letter by comments in his General
Orders of 31 August which emphasized
that, although Stringer had been ordered
to obtain the needed drugs and return at
once, he had now been absent from duty
33 days.3¢

Smallpox did not reappear in Gates’s
army, but other diseases also afflicted his
men, among them dysentery at a time when
the accepted remedies for this condition
were scarce, bilious, remittent, and inter-
mittent fevers, and scurvy; even worms ap-
parently added to the miseries of the
Northern Army. In September, one regi-
mental surgeon at Ticonderoga reported
that half of his regiment was unfit for
duty because of dysentery, jaundice, and
various fevers. Returns of late September
suggest that in the Northern Army at this
time, as many as 50 percent of all the en-
listed men assigned to the camp may have
been sick. Two to four times the number
sick away from camp remained under the
care of the regimental surgeons in their
tents or, quite possibly, within regimental
hospitals, a situation which may have re-
sulted from the fact that the general hos-
pital staff had not grown as rapidly as the
size of the army in the North.35

A committee of surgeons had drawn up
a list of the minimum drug supplies re-
quired by a battalion, which included
twenty pounds of bark, four pounds each
of gum camphor and powdered jalap, three

Siege to Retreat: 1775-May 1777 63

pounds of powdered ipecac and tartar
emetic, two pounds of powdered rhubarb,
and fifteen pounds of Epsom salts, along
with quantities of more than a dozen other
medicines. Several of these drugs might be
used to treat any one collection of symp-
toms, tartar emetic, followed by a combina-
tion of nitre, camphor, and tartar emetic,
for example, being one treatment for the
“ague and chills; a violent pain in the head,
back, and in every bone . . . with loss of
appetite, Nausea, and considerable degree
of weakness . . . succeeded with an inflam-
matory fever” which was seen in the fall
of 1776 in the North.%¢

Recognizing that the departments ina-
bility to provide adequate care for its pa-
tients threatened future recruitment, Gov.
Jonathan Trumbull of Connecticut wrote
General Schuyler that, rather than waiting
for a specific order from Congress, he
would send on clothing and medicines
whenever informed of the need.37

The Continental Congress reacted to re-
ports of the situation in the Northern De-
partment by ordering that the necessary
medicines be sent to the northern hos-
pitals and by sending an investigating com-
mittee to Ticonderoga. In view of reported
shortages of all kinds of food except bread
and meat, the Congress also ordered that
not only sheep but also cornmeal, rice, oat-
meal, and molasses be sent at once to the
Army’s patients in the Lake George and
Ticonderoga area.3®

Early in October, apothecary Craigie
commented that, although he had received
a wagonload of herbs, half of it consisted
of varieties he could not use, but Stringer,
now in Albany, wrote General Gates only
a few days later that he had been most
successful in obtaining medicines. He wrote
Potts, as he had on another occasion, that
he was sending along a portion of his sup-
ply, this time enough to fill two barrels
and a box, and added that he had more on
64 THE

hand should it be needed later. The picture
brightened further in November when a
member of Congress noted with satisfac-
tion that “Medicines are sent in sufficient
Quantities for the Army at Ticonderoga,”
and Potts was able to begin distributing
generous quantities of medicines to his
regimental surgeons.??

The alleviation of the drug shortage did
not mean that the problems of the Northern
Department were over. Items valued for
the hospital diet were still in short supply,
especially sugar, vegetables, and “spirits,”
money to pay the medical staff was almost
nonexistent, and the Fort George hospital
was badly overcrowded. Alarmed by the
possibility of an enemy attack which could
further burden this facility, Stringer at-
tempted to reduce its population by urging
that no more patients be sent to Fort
George, by discharging some from the
Army, and by sending still others to the
Albany unit, recently set up in a building
originally constructed as a military hospital
during the French and Indian War. In
November, when the anticipated attack
seemed imminent, despite Arnold’s success-
ful delaying action against British naval
forces seeking to gain control of Lake
Champlain, he sent 130 patients to Albany;
housing for as many as 500 patients and
an adequate supply of food were available
there, but medical attention was inade-
quate. Because of his need for medical
attendants, Stringer was unable to have a
senior surgeon escort these men.*°

Complaints about the number of pa-
tients Stringer’s department was discharging
from the Army, however, apparently be-
gan to appear in the summer of 1776, and
in September, Potts was ordered to discon-
tinue the practice. Stringer protested this
order to General Gates, maintaining that
the number for which he was required to
care was growing daily and that he had
but three surgeons and two mates at Fort

ARMY MEDICAL DEPARTMENT,

1775-1818

George to handle them. He added that he
believed that such discharges as had al-
ready been granted would have met with
the general’s approval.!

The committee sent by Congress to in-
vestigate Northern Department hospitals
reported in November that the Fort George
General Hospital contained 400 patients
who lacked only an adequate supply of
vegetables, “good female nurses and com-
fortable bedding.” Concluding that the
Fort George unit was too far from Ticon-
deroga to serve the troops there, it also
recommended that a building designed to
serve as a general hospital be constructed
on Mount Independence, a hill across a
narrow stretch of Lake Champlain from
Ticonderoga, where Potts was apparently
already prepared to care for the wounded
if any enemy attack should occur.*?

When no British attack had materialized
by December 1776, the Fort George hos-
pital was closed and all of its patients ap-
parently were moved to Albany, while Potts
was preparing to go home to Pennsylvania
on leave late in 1776. Having now dis-
missed Stringer, the Continental Congress
ordered Potts to return north at once in
February 1777, however, and by the end
of March he was again on duty in the
Northern Department,*® this time as its
acting Director.

By the time Potts arrived in the Northern
Department, conditions were sufficiently
stabilized for improvements to be scheduled
and carried out in a coherent manner. Gen-
eral Schuyler suggested that Potts leave the
Albany hospital to the care of others and
concentrate on preparing the Fort George
facility to house patients with contagious
diseases, as suggested by the congressional
committee the preceding November. It was
planned to house newly inoculated patients
there, but one wing of that hospital had
never been finished. A general hospital
was now being prepared on Mount Inde-
Ch. 3]

pendence, and General Schuyler wished
patients from the Fort George garrison,
presumably those not afflicted with diseases
considered contagious, to share this hospital
with those from Ticonderoga. Since the
Congress wished in addition to have a
vegetable garden planted on Mount Inde-
pendence, Potts had the additional prob-
lem of obtaining an adequate supply of
seeds. 4

The staff assumed by Potts when he
succeeded Stringer in the Northern Depart-
ment apparently consisted of three sur-
geons, an apothecary, nine mates, and a
clerk. The new Director had the same
difficulties as his predecessor in meeting the
payroll and also began to receive com-
plaints about the pay scale. Early in April,
however, he wrote General Gates that he
believed he had succeeded in persuading
all but one of his subordinates to stay on
even though the promised pay increase had
not yet materialized.*®

The new appointments for the Hospital
Department made in April (see Chapter
2) designated Potts Deputy Director for
the Northern Department and assigned him
as assistants, among others, Dr. Malachi
Treat, reputed to be “clever,” and another
physician,*¢ whose surgery the new Direc-
tor General, William Shippen, Jr., described
as “elegant.” His new and enlarged staff at
this time apparently consisted of an As-
sistant Director, a Physician General, a
Surgeon General, a Physician and Surgeon
General of the Army, an Apothecary Gen-
eral, six senior surgeons, seven mates, a
Commissary General and his assistant, two
clerks, and one steward.”

By the end of May 1777, conditions in
the Northern Department with its three
general hospitals at Mount Independence,
Fort George, and Albany were much im-
proved. The general hospital at Mount In-
dependence, for example, on 21 May re-
ported no great incidence of any one disease

Siege to Retreat: 1775-May 1777 65

among its patients but rather a variety,
from asthma and measles to inflammation
of the liver and “cough and hectic.” Al-
though Potts had appointed a private phy-
sician, one Dirk Van Ingen, to care for
army patients near Schenectady, there is no
evidence that this was done because of
crowding in the nearby Albany hospital.
Smallpox was under control, supplies were
adequate, patients were, for the most part,
housed in buildings specifically designed
for their care, the staff was large in propor-
tion to the number of patients, fresh vege-
tables were available from local gardens,
and evidence even indicates that sheep and
cattle were now being delivered on the
hoof. By May 1777, therefore, the Hospital
Department in the North was well prepared
to handle the casualties of another hard
campaign.®

NEW YORK AND NEW JERSEY,
1776 To 1777

For the estimated forty regiments defending
New York City, hospitals were initially
established not only within the city but
also on Long Island, where one of the five
divisions forming Washington's army of
about twenty thousand was stationed.*?
(Table 5)

On the island of Manhattan, hospital
units were located in the City Hospital,
newly rebuilt after a disastrous fire, in the
City Barracks, and even in rows of private
houses appropriated for the purpose by the
New York Convention, in some instances
outside the most populous areas, but the
principal unit was at King’s College. Mor-
gan later maintained that he had experi-
enced considerable difficulty in using pri-
vate homes. The state militia actually turned
patients out of houses on the Bowery and
one belonging to the Stuyvesants, where
they had been placed by the state legis-
lature. There were also instances where
regimental surgeons took over buildings
66 THE ARMY MEDICAL DEPARTMENT,

TABLE 5—PATIENTS IN HOSPITAL DEPARTMENT
UNITS, NEW YORK CITY AREA, APRIL-JUNE 1776

 

 

Admitted [Dismissed
Hospital Since Last| Fit for Remain-
Return Service (Dead ing

New York City

24 Apr—4 May" 70 7 3 57

4-11 May 60 15 1 101

11-18 May 85 28 2 156

18-25 May" 37 22 1 165

9-16 Jun © 20 31 4 136
Long Island

4-11 May 7 2 0 5

11-18 May 19 6 0 18

18-25 May 27 18 2 25
Smallpox Hospital,

Montresor’s

Island ¢

4-11 May 4 0 0 5

18-25 May 8 0 3 25

9-16 Jun 0 1 0 6

 

 

 

 

 

SOURCE: Return 24 Apr-25 May, 9-16 Jun 1776, signed
by Jeans Foster, RG 93, M246, roll 135, folder 3-1, items

a Three absent without permission.

b Three removed to the smallpox hospital,
without permission.

¢ Two discharged from the Army.

4 No return submitted for 11-18 May.

two absent

assigned to the general hospital. Asked to
collect herbs, however, the local populace
also helped to supply other needs of army
patients in the area, giving the hospitals
2,000 sheets, hundreds of shirts, and similar
supplies.5°

To Maj. Gen. Nathanael Greene's division
fell the assignment of holding Long Island,
and it was at General Greene's request that
a branch of the general hospital was estab-
lished to serve his troops. Morgan assigned
this Long Island unit to Dr. John Warren
when it began operations in the summer
of 1776 and ordered him to take three
hospital mates with him. Any further as-
sistance Warren might need could come
from among the surgeon’s mates of Gen-
eral Greene's brigade. On the question of
what medicines to bring with him, Morgan
told Warren to consult with physicians
Foster, Adams, and McKnight.5!

1775-1818

Morgan gave Warren detailed instruc-
tions on how the Long Island hospital was
to be managed. Careful records must be
kept of its patients, the time of their en-
tering and leaving the hospital, and their
diseases. In this instance, they could also
be allowed to remain under the care of
their own regimental surgeons in whatever
quarters General Greene might see fit to set
aside for this purpose. These surgeons were
even to be permitted to draw upon the
Hospital Department’s stores, but when so
doing, they were to consider themselves a
part of the Long Island hospital and un-
der Morgan’s authority. No supplies were
to be issued to patients not reported to
and considered as a part of the general
hospital. Nurses must be hired and each
nurse paid 50 cents a week. The regula-
tions for the unit’s personnel and patients
should be agreed upon by the surgeons,
read to the occupants of each ward, and
then posted, along with the rules for diet.
Both sets of rules must be most strictly en-
forced.5?

The regimental surgeons were to be re-
quired to keep careful records of their pa-
tients and to submit weekly returns to War-
ren of those of their patients being cared
for through the Long Island unit. Once
each month a roll was to be made out for
ration money and signed by the general.
The rations for these men to their regiment
were to be stopped while they were in the
care of the Hospital Department. Morgan
assigned a storekeeper to Warren's staff
and he was to apply, as appropriate, to
either the Commissary General or the
Quartermaster General for what he needed,
keeping strict accounts of such transactions.
Warren was instructed to obtain 100 blan-
kets and 100 beds to take to Long Island,
applying to the Quartermaster for straw,
and he was to be sure to have the nurses
and washerwomen clean these beds “from
time to time.” An “orderly Mate” was to be
placed in charge of hospital furniture and
Ch. 3] Siege to Retreat.
bedding and to keep careful records, which
were to include notations on what equip-
ment and clothing each patient brought
with him to the hospital.?3

Warren’s hospital was not long estab-
lished, however, before the British attack
in late August 1776 drove the Long Island
division, now under Maj. Gen. John Sulli-
van because of General Greene’s illness,
from the island. American losses ran high,
970 officers and men killed or wounded.
The patients from Warren's hospital had
to be moved in considerable haste to New
York City and placed in the barracks there.
A heavy rain was falling as the patients
were landed at various wharves and many
inevitably suffered as a result, but Morgan
personally took part in caring for them and
later maintained that he had not only at-
tended all the operations of which he was
aware but also dressed all the patients
himself.5*

When operations in the New York City
area were just in the planning stage, it had
been assumed that the city itself could
not be successfully retained unless, by
holding Long Island, the Continental Army
could make the city also untenable for
the British. It was, therefore, obvious that
if the British were to take Long Island,
New York City was doomed, patients in
the New York hospitals would have to be
evacuated, and hospital supplies and medi-
cines would have to be quickly moved to
a safer place for storage. (Map 3)

On General Washington’s order, Morgan
went to Newark several days before the
evacuation from New York was scheduled
to take place to set up a hospital for the
approximately one thousand patients from
Long Island. Here he established Foster
and Dr. William Burnet plus seven or
eight mates to assist them. Morgan had
sent Dr. Barnabas Binney to Philadelphia
in July to round up additional hospital
stores and in August had located some

: 1775-May 1777 67

himself. Although Binney could find no
instruments, the supplies arrived at New-
ark just before the patients themselves
were expected and were deposited at the
new hospital under the care of Assistant
Apothecary John B. Cutting.5®

Despite Morgan’s efforts, however, the
move of patients from New York City to
Newark led to a “dreadful scene of con-
fusion and disorder.” Some mates had been
taken prisoner and many nurses and other
attendants had fled. The militia had im-
pressed a considerable number of wagons
in the course of their flight, complicating
the moving of seriously ill and wounded pa-
tients to boats. The boats themselves were
late in arriving. Furthermore, the neighbors
of the new hospital were not pleased to have
an institution assumed to be a source of
fatal infections established near them. It
was also becoming difficult to obtain nurses
to care for the growing numbers of sick be-
cause, Washington believed, they were not
being paid enough. Men from the regiments,
therefore, were used even though their
services were of questionable value to the
sick.’® On 18 September, Washington was
forced to authorize regimental surgeons to
care for their own patients “until the Gen-
eral Hospital can be established on a proper
footing.” 57

The situation at Newark was made more
difficult by the Morgan-Shippen feud over
control of department hospitals in the New
Jersey area. Shortly after Morgans de-
parture from Newark, he received a visit
from Foster, whom he had left in charge of
the hospital there. Foster reported that Ship-
pen had attempted, albeit unsuccessfully, to
assume control over both the hospital and
the stores left in Newark. Washington, in
response to Morgan’s complaint about thi.
situation, wrote Shippen that he wished
Foster to remain in charge at Newark.%®

In addition to the Newark hospital, Mor-
gan also set up other hospitals in New
 

 

NEW YORK CITY

2 AREA

MILES

 

 

 

 

 

 

 

 

MARYLAND

 

D

Bethlehem

Allento wi ~

3

Easton

 
 

  

 
    
   

  
  
    
 
 
  

NEW

Morristown Fort Lee

Newark

JERSEY

Elizabeth

Princeton

Bordentown

0

NEW YORK |
O

Hackensack

Brunswick

CONTINENTAL ARMY
HOSPITAL LOCATIONS

   
         
     
 

Fishkill
Oo

West
Point {{ Peekskill <
O

LONG ISLAND

1776-1777
40

MILES

 

 

MAP 3

 

 

89

FINTIWLIVIdIdQ TVOIAAN ANWIY dH]

8I8I-SLLI
Ch. 3]

Jersey for the sick and wounded of General
Washington’s army. He supervised the es-
tablishment of a 300-bed facility at Hack-
ensack, New Jersey, where hospital supplies
had also been stored, a few days after he
opened the Newark hospital. By 18 October,
Morgan was able to move “several hun-
dreds” of patients to Hackensack despite
the fact that he had only three mates and a
surgeon to help him, that he had been for-
bidden the use of army workmen, that sev-
eral days’ more work was needed, and that
he had no guards to help him because the
fifty assigned managed within a short period
of time and on various pretexts to disap-
pear. Morgan was particularly anxious to
have his hospital in Hackensack running
smoothly so that he could leave it in War-
ren’s hands and join General Washington
at White Plains, New York, where action
was momentarily expected.5?

While Morgan attempted to care for the
men of Washington’s army, Shippen was
with the men of the militia’s flying camp at
Amboy. Chosen chief physician for the
camp on 15 July 1776, at a time when
fewer than 3,700 men had come in, he was
quite confident of success in spite of his
lack of military experience and the green-
ness of the new recruits which predisposed
them to illness. He at once placed appeals
in local papers asking the citizens of Phila-
delphia and nearby areas of Pennsylvania
as well as those of New Jersey to send old
sheets and linens to him for his hospitals
and he also began to collect a staff.%°

By mid-September, however, Shippen
found himself hard pressed and in great
need of surgeons, especially, he stated, in
view of the fact that seven or eight bat-
talions in the flying camp had neither regi-
mental surgeons nor mates of their own.
He was forced to act personally as both
director and surgeon at the Amboy unit as
well as apothecary for nine battalions. By the
end of September, however, he had added

Siege to Retreat: 1775-May 1777 69

to his staff at least two former regimental
surgeons, Bodo Otto, a native German who
had served with Pennsylvania troops in the
Battle of Long Island, and William Brown,
who had been recommended by both Gen-
eral Washington and the flying camp’s Brig.
Gen. Hugh Mercer. It is interesting to note
that even before the 9 October resolve
which placed him in command of all army
hospitals in New Jersey, the Continental
Congress apparently considered Shippen
chief physician for the entire New Jersey
area. Thus, in appointing Brown as Ship-
pen’s assistant, the Congress named him
assistant for the “flying camp and troops in
New Jersey.” 8!

As General Washington’s army retreated
south through New Jersey before the British
in the fall of 1776, the sick and wounded,
often numbering one-fourth to one-third of
the total, were sent ahead and placed in
temporary hospitals at Amboy, Elizabeth,
Brunswick, Trenton, Fort Lee, Newark, and
Morristown. On 1 November, Shippen sub-
mitted an optimistic report to Congress on
the hospitals in five of these towns, saying
that his two units at Amboy contained 90
sick and 7 wounded, that at Brunswick 10
sick, and that at Trenton 56 sick. At Eliza-
beth he recorded 54 sick, 3 wounded, and
25 “sick from Canada” and at Fort Lee, 75
sick, 9 wounded, and 19 “distressed New-
England Troops.” It should be noted that
even at a time of action, the sick outnum-
bered the wounded sixteen to one. Shippen
predicted that four-fifths of his patients
would recover but noted that 2,000 more pa-
tients who were not yet under his control
were scattered in barns around the country-
side. By late November, in spite of Shippen’s
optimism, patients from the flying camp,
unattended by physicians, were pouring
into Philadelphia, arriving in wagons and
threatening to spread putrid or camp fever
among the citizens of the city. Although he
must have been aware of the sickliness of
green troops, Benjamin Rush later tried to
70 THE ARMY MEDICAL DEPARTMENT,

claim that Shippen was to blame for the
flying camp’s high death rate at this time.
In November 1776, however, he wrote
Shippen that everyone was praising the
work he was doing. Washington personally
ordered the sick from Trenton moved to
Philadelphia so that his troops might use
the barracks which had formerly sheltered
Shippen’s patients and gave Shippen permis-
sion to use supplies in New Jersey which
Morgan had been moving about without
using. 5?

Hospital units in Philadelphia were under
Morgan’s direct control, but such a great
number of the Army’s sick was coming
into the city that the Council of Safety
asked the vacationing Jonathan Potts early
in December to take charge of them, ap-
parently under Morgan. Bodo Otto took
over the city’s Bettering House, and sev-
eral stores and private houses were also
pressed into service as hospitals. Philadel-
phians were asked to help to obtain the
supplies the Hospital Department needed
and many citizens served as volunteer
nurses. Morgan, with a possible British oc-
cupation of Philadelphia in mind, asked
faculty members of his own medical school
to stand by to care for patients too ill to
be moved. Soon, however, so many dis-
abled soldiers were quartered on local
citizens that Morgan ordered Potts to send
flying camp patients belonging to Maryland
units back to Maryland, adding that Potts
was to be sure that these men received the
best care, including warm housing and
blankets. A hospital was, therefore, estab-
lished in Baltimore under Dr. Samuel Mac-
Kenzie and a mate. Morgan urged that
others be accommodated in towns outside
Philadelphia. Despite the care and atten-
tion devoted to the patients remaining in
the city, however, the death rate was very
high. On 16 February 1777, a total of
4,745 of the 17,449-man army was re-
ported to be ill or unfit and some claimed
that as many as 2,000 military patients

1775-1818

were buried in the Philadelphia potter’s
field.6?

Washington was concerned with the
threat of contagion posed by the large
numbers of the Army’s patients housed in
Philadelphia and wished from the begin-
ning to sce hospitals established at a safe
distance from that city. Shippen moved his
family to join him at Bethlehem in early
December and, with the cooperation of the
Council of Safety of Pennsylvania, estab-
lished hospitals at Bethlehem, Allentown,
and Easton, Pennsylvania. In a letter urging
that he be sent the funds he was totally
lacking for the care of his patients, he re-
ported to his brother-in-law, Richard Henry
Lee, that as of 17 December his patients
were much reduced in number and doing
well. 64

The main hospital in Shippen’s system
occupied the former Single Brethren’s
House of the Moravian Order in Bethlehem.
This 83- by 50-foot building dated from
1748 and contained eight rooms on the
first floor of the main section. There were
also refectories, a chapel, and superinten-
dent’s rooms on the second floor and dormi-
tories plus several smaller rooms on the
third. More recently built east and west
wings housed further accommodations, in-
cluding workshops. Completing the com-
plex was a 40-foot belvedere or summer-
house open to the outside air. Shippen
filled the cellars of the former church
storehouse with hospital supplies and medi-
cines and assigned officer patients the up-
per rooms. The hospital guard, surgeons,
and convalescents were housed in shops
and other buildings on the western side of
town. A Moravian minister, the Reverend
John Ettwein, visited all the patients at
Bethlehem, the single brethren aided pa-
tients, the women made lint bandages, and
Moravian carpenters made the coffins and
dug the graves for 110 patients before the
survivors were transferred to Philadelphia
late in March 1777.9
 

 

 

 

Siege to Retreat: 1775-May 1777 71

 

 

 

BRETHREN’S HOUSE AT BETHLEHEM. (From Duncan, Medical Men.)

Patients began arriving in Bethlehem
early in December 1776 in all sorts of
transport and were initially so short of food
that the Moravians fed them for three days
until the Army’s supplies arrived. Shippen
was touched by the cooperation of the
townspeople and decided to house as many
of the former Morristown patients as pos-
sible at Easton and Allentown. These units
also were closed in March 1777 and patients
too sick to be discharged as convales-
cents were sent to Philadelphia. The men
who had been serving as nurses or orderlies
returned to their regiments, while the de-
partment began efforts to find women to
replace them.%¢

The last action before the Army went
into winter camp at Morristown involved
Washington’s surprise Christmas attack
upon Hessian units at Trenton and his

early January success against the British
at Princeton. The wounded from these oper-
ations and the sick from the camp at Mor-
ristown required the opening of new hos-
pitals and the reopening of some old ones
in New Jersey.

Christmas celebrations at Bethlehem were
interrupted by General Washington's call
to Shippen and his principal surgeons to
join him as he moved against Trenton. It
would appear, however, that Shippen did
not reach the general in time to take im-
mediate charge of the wounded, as on 29
December the general ordered that the
wounded from the initial Trenton engage-
ment be taken to Newtown, Pennsylvania,
just across the Delaware River from
Trenton, until Shippen and John Cochran
could have them moved farther.®” Fortu-
nately, few Americans were injured in this
72 THE ARMY MEDICAL DEPARTMENT,

engagement, but seventy-eight wounded
Germans surrendered. Since the Ameri-
cans wished to encourage such mercenaries
to desert the British cause, they paroled
these men and provided them with hospital
facilities and the care of their own surgeons.
An attempt was even made to give the
German surgeons instruments, but it was
reported that at least some of the ampu-
tating instruments so supplied were un-
usable.

Benjamin Rush had offered his services
to General Washington's army after the
Continental Congress adjourned on 12 De-
cember, and he and Cochran assumed re-
sponsibility for the Continental Army’s
wounded at Trenton just before the gen-
eral began his withdrawal toward Princeton.
It would appear that General Washington
not only took no physicians with him on
this march but also failed to inform Rush
and Cochran that he was leaving. Cochran
discovered the Army’s departure on 3
January 1777 only when he rode out in
search of it. Rush and Cochran were at
the time caring for about twenty American
wounded who were in danger of being cap-
tured by the British. The surgeons hastily
obtained wagons and horses and removed
their patients to Bordentown, southeast of
Trenton, apparently assuming that this
would be Washington’s destination. Three
days later they moved their unit to Prince-
ton, where on 7 January 1777 Rush wrote
Richard Henry Lee of the serious (and soon
to prove fatal) wounds of General Mercer.
Since many other Americans were also
wounded in the Princeton engagement, a
hospital was set up in the College’s Nassau
Hall. Here Rush and the other surgeons,
possibly including Potts, with the aid of a
surgeon and five privates left behind for
the purpose by the British, cared for both
American and enemy wounded until the
end of the month when Rush, considering
his patients to be out of danger, left to re-
join the Continental Congress.%

1775-1818

IN NEW YORK

STATE AND NEW ENGLAND

AFTER THE EVACUATION OF
NEw YoRrRK CITY

HosPITALS

Some of the wounded from action in the
vicinity of New York City were cared for
in hospitals in New York State and in New
England. (See Map 3.) After opening the
hospital at Hackensack, New Jersey, in
October 1776, Morgan had hurried toward
White Plains, New York, where action was
momentarily expected. When he arrived at
his destination, he found that the depart-
ment’s surgeons had already decided upon
a church at North Castle as the site for a
general hospital. The supply situation, how-
ever, had not been solved, since, despite
orders to the contrary, the regimental sur-
geons of Maryland units had arrived at
White Plains expecting Morgan to let them
have what they nceded. Many regimental
surgeons were not even present, despite
both orders to the contrary and the fact
that the sick and wounded were numer-
ous.%

As soon as action was joined, on 28
October, Morgan and his surgeons set out
for White Plains from North Castle, while
mates followed them with wagons carrying
instruments and dressings. They established
themselves near the front lines in houses
along the road to North Castle and re-
mained there, according to Morgan, about
a week, until the enemy withdrew and
Washington left to cross the river in an
attempt to defend Fort Washington, on the
northern end of Manhattan Island. During
this engagement, Morgan was able to return
to North Castle only briefly and at least
one surgeon and three or four mates were
also on duty at White Plains, awaiting pos-
sible further action. Morgan kept surgeons
Samuel Adams, Jr., and Charles McKnight
at North Castle, and sent some one thou-
sand patients to Stamford and Norwalk,
Connecticut, under the care of physicians
Philip Turner and William Eustis.”
Ch. 3]

While Morgan was at White Plains, the
British took Fort Washington and also Fort
Lee, opposite Fort Washington on the west
bank of the Hudson River, and then began
to drive General Washington south through
northern New Jersey. After leaving instruc-
tions with his surgeons, therefore, Morgan
moved to join General Washington, catching
up with him not long after the army
crossed the Delaware River.™

Among the hospitals Morgan left behind
him was that at Stamford, in charge of
Turner, whose unit cared for 1,200 to 1,300
patients from early November to February
1777, by which time only 25 remained.
Eustis was in charge of the hospital at Nor-
walk, where approximately 700 patients
were sheltered in the course of the late
fall of 1776 to March 1777, when only 8
to 10 patients remained.”

For help in supplying these two hos-
pitals, Morgan was forced to turn to Gov.
Jonathan Trumbull of Connecticut, who
sent Turner a significant supply of necessary
items. It was ironic that Morgan’s need in
Connecticut was so great, for about eight-
een tons of supplies from New York City
had been moved by boat to Stamford just
before the evacuation of that city and stored
in a private home there. Not long after
these supplies arrived in Stamford, they
were moved, without either Morgan’s
knowledge or General Washington’s ap-
proval, but their new location was only
fifty miles from Stamford and Morgan
could easily have reached them. Unfortu-
nately, however, while Morgan’s most
urgent need at this time was for medicines,
the bulk of these supplies consisted of
blankets, bedding, sheets, and new shirts.”

Among the hospitals set up by the Hos-
pital Department in New York State were
units at Kingsbridge, on the east side of the
Hudson opposite the northernmost tip of
Manhattan Island, and at Fishkill, on the
Hudson River not far from West Point,
both of which served the men of Maj. Gen.

Siege to Retreat: 1775-May 1777 73

 

WiLLiam Eustis. (Courtesy of National Li-
brary of Medicine.)

William Heath’s army. The hospital at
Kingsbridge cared for the sick and wounded
of a still raw and undisciplined army in a
filthy camp entirely devoid of sanitation. A
form of diarrhea termed “putrid” resulted
from the unhealthy conditions, and one
surgeon commented that “Many died, melt-
ing as it were and running off by the
bowels.” Aid from the Quartermaster’s De-
partment was almost impossible to obtain
for this hospital, according to Morgan, and
medicines were so short that the capture
of a chest of medicine from the enemy
was deemed a noteworthy event.’

After the loss of the White Plains en-
gagement, General Washington sent Gen-
eral Heath’s division north to Peekskill and
West Point and stationed General Lee on
the Croton River south of Peekskill. Both
divisions thus remained on the east side
of the Hudson River, where Morgan still
directed the department’s hospitals. Before
74 THE ARMY MEDICAL DEPARTMENT,

leaving to join General Washington near
Trenton, New Jersey, Morgan set up a
hospital for General Heath’s division at
Peekskill, in response to the complaint that
the sick and wounded of this 5,000-man
division were receiving inadequate care.
Morgan initially suggested that General
Heath find appropriate quarters to shelter
300 sick and that the Hospital Department,
now free to expand its staff to match the
Army’s growth, then staff the unit. The
Director General added, however, that he
believed Peekskill to be an unhealthy loca-
tion for a hospital. Morgan put Adams
and McKnight in charge of the new hos-
pital, but they were unable to find a satis-
factory site near the town and finally took
over accommodations at Fishkill, twenty
miles to the north, for their hospital. Gen-
eral Washington, however, ordered that
convalescents be sent to Peekskill. On Mor-
gan’s dismissal in January 1777, General
Washington requested that Dr. Isaac Foster,
as the “eldest surgeon,” take over the
temporary supervision of these hospitals on
the east side of the Hudson River.”

Until mid-1776, official policy called for
the prevention of smallpox epidemics
through isolation only and rejected planned
inoculation. When General Washington’s
army moved south from Boston, a smallpox
isolation hospital was established on Mon-
tresor’s Island (now Randalls Island) in
the East River and a twenty-three-man
guard of men who had already had the
disease was assigned to it. Although there
had been some inoculations at the Mon-
tresor’s Island hospital in the spring, in
May, General Washington ordered that
there were to be no more. All those al-
ready inoculated or exposed to the disease
were to be sent there. (See Table 5.) The
general warned that “any disobedience to
this order will be most severely punished.”
The Continental Congress supported Wash-
ington’s stand and when a private physician
in the State of New York was discovered

1775-1818

to have been inoculating soldiers, he was
jailed.”®

Despite these precautions, the fear of
smallpox grew among the men of the
Continental Army. Recruiting was threat-
ened, and by late June, official attitudes
toward inoculation began to show signs of
change. The Maryland Council of Safety,
noting the presence of smallpox among
some of the Maryland troops, suggested
that inoculation be tried and even offered
to pay for such a step, but the Council
of Massachusetts, learning that Maj. Gen.
Artemas Ward was permitting the inocu-
lation of some of the troops outside Boston,
where this procedure was illegal, asked
that the practice be stopped.”

General Washington found that, despite
all precautions, most units contained a few
infected men who posed a threat to the
entire regiment in which they served. And
by August official attitudes were apparently
changing in favor of inoculation in segre-
gated camps. Orders again were issued
specifically forbidding private and secret
inoculation, but the prohibition brought
protests, since it was believed that such
a rule would hinder recruiting, especially
for the Northern Army."

Since General Washington and the Hos-
pital Department still feared the possibility
of triggering an epidemic, careful precau-
tions were planned to ensure the isolation
of soldiers undergoing inoculation. The gen-
eral suggested moving them out of Phila-
delphia and into nearby segregated hos-
pitals. And when he sent John Cochran to
Newtown, Pennsylvania, to oversee inocula-
tion there, he suggested that houses in the
remote countryside be used to shelter newly
infected soldiers. General Washington
urged that those already inoculated not be
moved until entirely recovered and that
when they left the hospital they be equipped
with either new or “well washed, air’d and
smoaked” clothing. By mid-February, he
was also suggesting that the individual
Ch. 3]

states immunize their recruits before send-
ing them to join the Army. Rush, as chair-
man of the Medical Committee of the Con-
gress, wrote Washington that troops com-
ing in from the South were terrified of
contracting smallpox naturally and, since
the disease was raging in Philadelphia,
should be inoculated somewhere outside
of that city.™

It was in February 1777, while the bulk
of Washington’s army was in winter camp
at Morristown, that the official order to
proceed with the inoculation of the entire
army was given. The Continental Congress,
then meeting in Baltimore, ordered spe-
cifically that the troops there be immunized
and requested the Maryland Assembly to
give MacKenzie the necessary medicines.
On 5 February, the general, convinced that
only inoculation would prevent the destruc-
tion of his army, decided that all soldiers,
including recruits, at Morristown and in the
Philadelphia area should undergo the pro-
cedure.

The Hospital Department, although now
without a Director General and in a state
of disorganization after the dismissal of
Morgan, nevertheless immediately moved
to carry out the wishes of Congress. Ship-
pen ordered Dr. Bodo Otto to leave Phila-
delphia for Trenton, where he was to set
up an inoculation hospital in an old bar-
racks originally constructed for British
troops in the French and Indian War. Gen-
eral Washington personally told Dr. Na-
thaniel Bond to prepare to inoculate troops
in the Morristown area, emphasizing that he
wanted the procedure administered secretly
and as quickly as possible. Bond was to im-
munize not only the troops already in Penn-
sylvania and New Jersey but also all those
coming into the area, upon arrival.

A few minor complications arose as the
process of immunizing General Washing-
ton’s army began. The general was unhappy
that so many troops were being marched
all the way to Morristown before being

Siege to Retreat: 1775-May 1777 75

inoculated, since the facilities were not as
good there as elsewhere. Some confusion
existed in the area supervised by Foster,
and that doctor claimed that he had been
told that the order to inoculate the troops
in the Fishkill area had been counter-
manded. General Washington told Foster
that he had never intended to cause any
delay in the inoculation of these troops,
since waiting so long to begin the procedure
had already had harmful effects.5!

Distressed that Virginia still did not permit
inoculation, General Washington wrote
Gov. Patrick Henry to support the repeal of
such restrictions, adding that smallpox “is
more destructive to an Army in the Natural
way, than the Enemy’s Sword.” 82 These
regulations were apparently changed short-
ly after General Washington's request,
since on 23 April, the Continental Congress
ordered Dr. James Tilton to Dumfries, Vir-
ginia, “to take the charge of all continental
soldiers that are or shall be inoculated”
there and on 30 April decreed that troops
from Carolina stop at Dumfries, Colchester,
and Alexandria, all in Virginia, to undergo
the procedure.

In having his entire army inoculated dur-
ing the winter and early spring of 1777,
General Washington took a great risk. The
procedure would in a short time greatly
strengthen his army, but it temporarily
weakened his forces in the face of the
enemy. Only four of every 500 of his men
died as a result of inoculation, however,
and the gamble was so successful that he
repeated it in the Valley Forge winter of
1778.84

By March, General Washington had sent
a large proportion of his troops north to
the Hudson River, and only 3,000 remained
at Morristown, two-thirds of them militia
whose terms of enlistment were about to
run out. French arms and supplies were
now arriving, however, and in a short time
new units also began to come in. By May
there were 8,000 men at Morristown, but
76 THE ARMY MEDICAL DEPARTMENT,

2,000 of them were soon sick. Furthermore,
an epidemic of fever was raging in one of
the Army's facilities in Philadelphia, where
Benjamin Rush reported that most of the
staff had been ill at one time or another and

1775-1818

several surgeons and mates had died.®
Thus, despite his precautions, it was with an
army weakened by sickness that General
Washington ooened the spring campaign in
May 1777.
4

Year of Despair and Hope,
June 1777 to June 1778

During the 1777-78 campaign season, the
crucial victory over the British at Saratoga
in October 1777 brought action in the North
to an end for the scason and, for all prac-
tical purposes, for the war. In the Middle
Department, however, repeated military
setbacks as Washington unsuccessfully at-
tempted to defend Philadelphia and the
grim winter at Valley Forge which followed
placed demands upon the Hospital Depart-
ment in the New Jersey-Pennsylvania area
which it could not meet.

THE MIDDLE DEPARTMENT

As Washington retreated before the British
in Pennsylvania, the Hospital Department
was forced to move seriously wounded and
ill patients from place to place in all kinds
of weather in open and springless wagons.
Villagers who lived along the evacuation
routes long remembered hearing ‘the
wounded cry as they passed over the
stones.” ! The shortage of both housing and
clothing led to the overcrowding of poorly
clad patients in inadequate facilities and
the rapid spread of what was then called
putrid fever, making a shambles of what-
ever hopes may have arisen as a result of
the reorganization of April 1777 under the
leadership of the new Director General,
William Shippen, Jr.

Troops in the New Jersey-Pennsylvania
area saw no major action until September
of the new season since during the early
summer the maneuvers of the British gen-
eral, William Howe, in an attempt to force

the Continental Army to give battle in the
vicinity of Brunswick and Amboy, New
Jersey, were in vain. In July he embarked
15,000 men, about two-thirds of his army,
in the waiting ships of the British Navy and
disappeared over the horizon. During the
following six weeks, several sightings of the
enemy fleet led to varying predictions of
General Howe’s ultimate intentions, and
General Washington, trying to anticipate the
enemy’s next move, led his forces north to
the Hudson River and then south again to
New Jersey and Pennsylvania.?

General Washington's troops were far
from healthy during this time. Of an army
of roughly 18,000, more than 3,500 were
sick, according to a Medical Committee re-
port of 5 August 1777.2 The general blamed
the high rate of sickness upon the excessive
use of “animal food, untempered by Vegi-
tables, or Vinegar, or by any kind of Drink,
but Water and eating indifferent Bread” and
continued his efforts to improve not only
the diet and camp sanitation affecting his
troops but also the conduct of his regimental
surgeons and the management of the hos-
pitals caring for his men. He ordered that a
list of the sick in each regiment be made
every day and turned in to the regimental
surgeon. He required that these doctors
neither go on leave nor hospitalize a patient
without permission from Dr. John Cochran,
Physician and Surgeon General of the Army,
or his deputy.*

By July, however, the situation had not
improved and Cochran’s problems were mul-
tiplying. Although his letters do not reveal
 

CONTINENTAL ARMY

HOSPITAL LOCATIONS
June 1777-June 1778
0 20

 

 

   

  
  
   

<
@
oS
<
©
3
S
>
©

   

 

    
   
   
 
  
  
   
       
        
    
 
  
  

  

Morristown
MILES 0
Mendham
x Northampton
$ 0 NEW JERSEY
3 Easton
S Allentown O
Bethlehem
PENNSYLVANIA Abe
Brunswick
Plumsteadbville
Princeton
— ]
Reading Buckingham
Faulkner 0
Schaefferstown Swamp
Pottsgrove Pennypacker Mills Trentin
Resmstows ; Skippack North Wales
oO French Creek Limerick O o
Manheim  O Ephrata Warvick Trappe Bordentown
O arwie oO Phoenixville Evansburg )
Lititz Bristol
Yellow
Springs O valley Germantown 0
oO Forge Burlington
Lancaster lorie 0, g
Ome. Hoi

PHILADELPHIA

Fort Mercer

 

 

8L

‘LNIW1l¥VddQg TVOIAAW AWYIYY dH]

8I81-SLLI
Ch. 4]

precisely what it was that Cochran had done
to offend, Cochran was under fire from Maj.
Gen. John Sullivan, who regarded this phy-
sician’s attitude as insulting. Furthermore,
General Washington’s very recently issued
orders that regimental surgeons report twice
weekly to Cochran on the patients in their
care were apparently all too frequently ig-
nored. On 9 July, he announced that sur-
geons continuing to disobey him in this
matter were to be arrested.”

When the general turned his attention to
the facilities caring for his men, he dis-
covered that interference from his officers
was undermining the authority of hospital
physicians. Commenting that doctors should
be in complete control of these units, he
ordered that no officer visit such a facility
except to check on the treatment of its
patients or to help maintain order and dis-
cipline. In September, he also ordered that
officers not remove patients from hospitals
without the written permission of the phy-
sician in charge.’

The situation as far as hospitals were
concerned seems to have been satisfactory in
August 1777, however, Dr. Benjamin Rush
claiming at that time that “great order,
cleanliness, and the most perfect content-
ment prevail in our hospitals.” By the end of
that month, his army’s march slowed by the
presence of unfit soldiers still under the
care of regimental surgeons, General Wash-
ington had decided to turn all the sick over
to the hospitals rather than attempt to take
them with him on further moves about the
countryside.”

In September, the British landed at the
head of the Chesapeake Bay and Continental
units saw their first real action of the season
when General Washington attempted to
stop the enemy at Chadd’s Ford on the
Brandywine Creek in Pennsylvania on 11
September 1777. (Map 4) Contemporary
estimates of the losses suffered here by
General Washington’s army vary widely,
but a modern authority estimates 200 killed

Despair and Hope: June 1777-June 1778 79

and 500 wounded. Failing to stop the
British at the Brandywine, the Continental
Army moved northeast to the Schuylkill
River and then retreated northwest along
that river. After using a surprise bayonet
attack to defeat Brig. Gen. Anthony Wayne
at Paoli on 21 September, on the 26th the
enemy occupied Philadelphia unopposed.
The Continental Army lost an estimated 100
wounded at Paoli and another 500 in
wounded on 4 October through the defeat
of General Washington's army at German-
town. By 24 November 1777, wounds and
disease had crowded Middle Department
hospitals with approximately three thousand
men, a figure which did not include those
under the care of regimental surgeons.®
(Table 6)

The walking wounded from the Brandy-
wine defeat appear to have been directed
toward the Hospital Department’s facili-
ties in Philadelphia, and the more seriously
injured were taken in open wagons, escorted
by physicians, to such New Jersey hospitals
as those at Trenton and Princeton. Dr. John
Augustus Otto, one of the sons of the Dr.
Bodo Otto who was director of the bar-
racks hospital at Trenton, accompanied one
group of wounded to his father’s unit. Here
he stayed until the fall of Philadelphia
necessitated the abandonment of that hos-
pital. Another group of the wounded, es-
corted by Dr. James Tilton, went in slow
stages to Princeton, stopping on the way
in Philadelphia and Bristol, Pennsylvania,
and Trenton. Tilton later claimed that the
quarters these men were assigned at Otto’s
hospital had not been cleaned and that his
patients contracted putrid fever there. The
commissary of the Trenton hospital, Otto,
and a second son, Frederick, who also
worked with his father, however, maintained
that the rooms had been cleaned before
Tilton’s arrival and that there had been no
putrid fever in their hospital for three weeks
before that date. It was true, at any rate,
that Tilton and many of the Brandywine
80 THE

 

Bobo Otto. (From James E. Gibson, Dr. Bodo
Otto and the Medical Background of the

American Revolution, 1937. Courtesy of
Charles C Thomas, Publisher, Springfield,
Il.)

wounded with him did develop ‘“languor
and listlessness of the whole body, and a
peculiar sensation of the head, as if it were
tightened or compressed” shortly after their
arrival in Princeton. After some days, other

ARMY MEDICAL DEPARTMENT,

1775-1818

symptoms appeared, and “the pulse began to
sink, a dry tongue, delirium” developed.
Tilton noted that “If I ever saw the
petechiae, so much dwelt upon by Pringle
and Monroe, I have forgotten all about
them. This I am sure of, they were not re-
garded as essential to the disease.” ?

The most seriously injured from Brandy-
wine received emergency care in buildings
near the battlefield and were then collected
by the victorious British and removed to the
Wilmington area. General Howe told Gen-
eral Washington shortly after the battle that
Continental physicians would be permitted
to visit and treat wounded Americans held
by the British. The Continental general re-
sponded by sending Rush, whose subsequent
experience with the British system left a
lastingly favorable impression, four other
doctors, a hospital mate, and several other
attendants through the lines.!?

The fall of Philadelphia forced the evacu-
ation of facilities within the city and
rendered nearby hospitals vulnerable to sur-
prise raids by the British. It also made
necessary the establishment of new units at
more distant locations. After the Brandy-
wine defeat, Shippen had written a Moravian
leader at Bethlehem, Pennsylvania, to ask
the aid of his order in locating permanent

TABLE 6—MIDDLE DEPARTMENT HOSPITAL PATIENTS, 24 NOVEMBER 1777

 

 

Location Sick " Wounded Convalescent Total
New Jersey
Burlington 80 10 11 101
Trenton 112 0 102 214
Princeton 139 130 10 279
Pennsylvania
Buckingham 239 10 10 259
North Wales 100 0 59 159
Skippack (Shippack) 90 0 20 110
Easton 253 40 107 400
Bethlehem 161 80 142 383
Allentown 81 9 100 190
Reading wit £30 290
Lancaster Gow ce pe 300
Manheim * 17 3 40 62
Maryland
Baltimore 37

 

 

 

 

 

NOTE : Excluding regimental and brigade hospitals; as reported by William Shippen.
a Mistakenly listed as Mendham in Duncan, Medical Men, p. 239
Ch. 4]

accommodations in that area for an esti-
mated two thousand patients; and in late
November and December, many of the
patients from New Jersey facilities at Mount
Holly, Bordentown, Burlington, and Trenton
were moved to Princeton. General Wash-
ington feared for the safety of the Prince-
ton unit and urged unsuccessfully that it,
too, be moved. Other patients, including
those from such Pennsylvania hospitals as
the units at Bristol, Pottsgrove, and Bucking-
ham, were evacuated to the west and north-
west deeper into Pennsylvania, where new
hospitals were established at Lancaster,
Lititz, Ephrata, Reading, Easton, Allen-
town, Warwick, Reamstown (Rheimstown),
and Northampton. The closing of so many
hospitals, however, and the distance to the
new facilities made it necessary to open
temporary hospitals at Evansburg, Trappe,
Pennypacker Mills, Faulkner Swamp, and
Skippack, Pennsylvania. These units handled
the 421 wounded from Germantown before
they were moved even farther west within
the state.!!

Those patients in General Washington’s
army who had accumulated under the care
of regimental surgeons since the army had
first seen action in the fall of 1777 were
removed to units of the general hospital
when the army went into winter camp at
Valley Forge. Reports to the Adjutant Gen-
eral concerning the number and location of
patients still with the army were required
in anticipation of this move. Dr. Charles
McKnight and a colonel were told to pro-
vide wagons, but only for those patients
unable to walk even when relieved of their
packs. Three days’ provisions were to be
sent with these men and one officer from
each brigade was to accompany them to
ensure their receiving proper care. Dr.
Jonathan Potts, again on leave from the
Northern Department, had volunteered his
help in this massive evacuation, and Shippen
wrote him to point out that patients being
taken to hospitals on the west side of the

Despair and Hope: June 1777-June 1778 81

Schuylkill River would eventually pass
through Potts’s hometown of Reading. Ship-
pen asked his colleague to supervise these
men during their stay in Reading and to
do what he could to obtain for them com-
fortable transportation to their final desti-
nations.!?

The evacuation of so many hospitals, the
overall increase in the patient load, and
outbreaks of disease added to the burden of
the Hospital Department even in hospitals
which were not relocated. Nevertheless, in
early December, although Tilton maintained
that the Princeton facility’s patients at this
time were vermin-infested and filthy, Rush
did not seem unduly alarmed. When he
wrote Shippen from Princeton, he limited
himself to explaining his need for cooking
utensils, straw for bedding, and similar items
and mentioning plans to take over the local
Quaker meetinghouse and the home of a
Tory to expand to 1,000 the capacity of
his unit, which was already using the col-
lege’s Nassau Hall and a church. Rush’s
letter of the same day to Maj. Gen. Na-
thanael Greene also gave no indication that
the doctor was particularly upset by condi-
tions at Princeton, although he did note
that since many of the patients in his hos-
pitals were only slightly ill and tended to
spend their time stirring up trouble, he
needed two or three officers to enforce
discipline. In mid-December, however, Rush
pronounced the situation at Princeton fright-
ful. One building, which was large enough
for only 150 men, now held 400, he said,
and in one three-day period, twelve soldiers
had died of putrid fever. Since the past
spring, he added, six surgeons had died of
fevers contracted at the Princeton hospital
and there were still no guards present to
enforce discipline.'?

The necessity for reopening the hospital
at Bethlehem had apparently distressed
Shippen, who wrote the Reverend John
Ettwein of his regret that he was “obliged
by Order of Congress to send my sick and
82 THE ARMY MEDICAL DEPARTMENT,

wounded to your peaceable village . . . I
am truly concerned for your Society and
wish sincerely this stroke could be averted.”
By the end of September, both civilians and
soldiers were pouring into the village. Less
than three weeks after the defeat at German-
town, there were reportedly more than 400
men in the Single Brethren’s House, where
physicians considered 360 to be an absolute
maximum. The wounded coming in after the
Germantown engagement were frequently
sent on to Easton, but those too seriously
injured to be moved farther were placed
in tents at Bethlehem. Despite the crowded
condition of the Bethlehem hospital, in
October, Rush, as Physician General,
ordered that 100 more be taken in.

Because of such severe overcrowding in
the Single Brethren’s House, steps had to
be taken to add to the available accommoda-
tions. Early in November, seventy patients
were sent to a nearby farm. Rooms not pre-
viously used for patients, such as the Kkit-
chen, also were taken over. A separate hos-
pital was set up nearby at the Fulling Mill,
where woolen cloth was made. The sug-
gestion that one or more of the women’s
buildings be used, however, caused so much
dismay among the Moravians that the idea
was abandoned. Sixteen members of the
Continental Congress, including Richard
Henry Lee, John Hancock, and both Samu-
el and John Adams, signed a message at
this time recognizing the Moravians’ ‘“hu-
mane and diligent attention to the sick and
wounded” and calling for the protection of
their “persons or property.” 1%

The situation in the middle states as
General Washington’s army prepared to
take up winter quarters at Valley Forge
did not inspire optimism. Shortages of all
kinds, especially of housing, made it impos-
sible to provide care compatible with the
standards of the time. Severe overcrowding
alone was considered by one physician to
have been responsible for at least half of the
large number of deaths which occurred in

1775-1818

the early winter, although precise record-
keeping was often impossible where the
turnover was so great.!¢

A large number of the higher officers
of the Hospital Department came into Penn-
sylvania during the winter at Valley Forge.
Among them were, in addition to the Direc-
tor General, the leading members of the
staff for the Middle Department, including
the new Deputy Director and Purveyor, Dr.
Jonathan Potts; the Surgeon General (soon
to succeed Rush as Physician General), Dr.
William Brown; and Cochran, the Physician
and Surgeon General of the Army. Also
serving in this area were two Assistant
Directors, Dr. Thomas Bond, Jr., and Dr.
James Craik; and two Apothecaries General,
Dr. Andrew Craigie, who left the Northern
Department at about the same time as Potts,
and Dr. John Brown Cutting, who had ap-
parently been asked in the summer of 1777
to take charge of the buying of drugs of the
entire Hospital Department. Also present
at Valley Forge was Baron von Steuben,
whose Regulations for the Order and Dis-
cipline of the Troops of the United States,
enacted into law by Congress in March
1779, formalized those doctrines on hygiene
long preached by British and Continental
military physicians.!?

Food, clothing, bedding, drugs, instru-
ments, bandaging, even wagons for moving
supplies were all very difficult to obtain at
this time. The spring of 1778, furthermore,
brought an increase in the number of men
sent to hospitals because of disease, enhanc-
ing the effects of these shortages and leading
Craik to warn, “if I am not supplied with
what I write for, it will be impossible for me
to give satisfaction here.” 18

The scarcity of clothing affected not only
patients being treated in hospitals but also
those ready to return to duty. Those who
entered more or less fully clothed often
could not leave when recovered because
the clothes they had turned over when they
were admitted could not be found. Those
Ch. 4]

in the hospital, moreover, had so little to
wear while in bed that an adequate supply
of blankets assumed a crucial importance.
General Washington ordered that the items
of clothing a patient wore on entry into the
hospital be carefully recorded before storage.
Those belonging to patients who died in the
hospital were to be saved for men return-
ing to duty. The Continental Congress ap-
pealed to the clergy in the Middle Depart-
ment for donations of linen and woolens for
the sick and wounded, and in February,
General Washington ordered the Clothier
General to supply both sick and convales-
cent patients.!?

General Washington also was distressed
by the inadequacy of supplies of food and
bedding for hospitals. In January 1778, he
ordered the Quartermaster General to draw
upon his supplies of straw to meet the re-
quests of army doctors and to see that the
huts used for the sick at Valley Forge be
kept well supplied. In February, he also
ordered the Commissary General, Ephraim
Blaine, to keep the army’s sick supplied
with rice, or, if it could not be found, at
least with the ubiquitous cornmeal. Blaine
and Potts, however, were in conflict for the
purchase of many items and Blaine at-
tributed some of the higher prices to the
competition from Potts, so that whole-
hearted cooperation between the two men
was unlikely. Furthermore, since Blaine was
not always able to meet his regular com-
mitments, it was not easy for him to aid
Potts significantly. A more direct approach
to the problem of buying food for the
sick involved sending several men from
each regiment out to scour the neighbor-
hood for such food as could be obtained
“from local farmers and transferring supplies
from the Northern Department where, after
the victory at Saratoga, the demand had
begun to drop. Because of these steps, com-
bined with the efforts of the new Quarter-
master General, Nathanael Greene, and the
milder weather which facilitated transporta-

Despair and Hope: June 1777-June 1778 83

tion, by April, adequate amounts of flour,
beef, and bread were available in the Mid-
dle Department. In May, however, when
the army was preparing for the new cam-
paign, many other items were still in short
supply, among them sugar, tea, coffee,
chocolate, salt, wine, and vinegar as well
as bedding, paper, and pots. By June,
difficulties obtaining food for the sick led
General Washington to direct the Commis-
sary General of the Army to be prepared
at all times to supply the sick with fresh
foods.2?

Medicines were difficult to obtain through-
out the entire winter of 1777-78. General
Washington’s January order that the Direc-
tor General furnish medicines for regimental
chests was not carried out until April
because of the shortage of the required
drugs. Department members traveled to
neighboring colonies in their search for
medicines and considerable ingenuity was
shown in acquiring what was needed; the
Department turned to the Commissary of
Military Stores for sulfur and oil and to
the Northern Department for other medi-
cines.?!

The shortage of instruments experienced
in the early weeks of Dr. John Morgan’s
administration also continued during the
winter of 1777-78, when many regimental
surgeons were still unable to obtain so much
as a lancet. Lint and bandages were also
hard to find in Pennsylvania. To alleviate
this problem the department encouraged
Moravian women at Bethlehem and Lititz
to make lint and drew once more on the
generous supplies of the Northern Depart-
ment. Apothecary General Craigie also sug-
gested that the shortage of bottles be relieved
by reopening the glassworks at Manheim,
Pennsylvania.??

The shortages of medicines, bottles, in-
struments, and other items usually contained
in the regimental surgeon’s medicine chest
led inevitably to delays in the distribution
of these chests. Cutting sugested that when
84 THE

the new, smaller, and standardized chests
were ready, the larger ones be called in for
replacement. Concern over the nced for
these medicine chests was expressed by
General Washington himself, who ordered
that regiments without chests be reported to
Cutting as Apothecary General of the Mid-
dle Department. In May, however, Cutting
“went away before the regimental chests
were finished” and there was “a great
clamor about them,” since sufficient medi-
cines to keep all regiments supplied were
still lacking.??

Such drugs as were available to the Hos-
pital Department in Pennsylvania were ap-
parently stored initially at Manheim, but in
March 1778, Shippen ordered them moved
to Yellow Springs. Craigie, however, under
the assumption that there would be some
consolidation of hospitals in the area in the
future, wanted to locate the main depot at
Carlisle, Pennsylvania, and to have medi-
cines and chests prepared there. He noted,
however, that he had not been able to induce
the masons at Carlisle to complete the re-
quired construction for such a depot and
commented in a letter to Potts that “The
department is at present in chaos—no regu-
larity—no system,” even though needs were
“great and many.” 24

In addition to the shortage of supplies
and medicines, many serious conditions af-
flicted the men at Valley Forge. Those most
frequently experienced included a typhus-
typhoid type of fever and smallpox, the lat-
ter for the most part apparently through
inoculation. While neither of these condi-
tions posed a serious problem in the camp
until spring, frostbite injuries during the
winter were at times so severe as to necessi-
tate amputations. There was, moreover, at
least one minor ailment which, without
threatening life, tormented the men at
Valley Forge. This was “the Itch,” or
scabies. Baron de Kalb wrote back to
France that Continental soldiers were severe-
ly affected even before they camped at Val-

ARMY MEDICAL DEPARTMENT,

1775-1818

ley Forge, and General Washington ordered
regimental surgeons to obtain the necessary
sulfur from Cochran and to see that men
with this condition were “annointed for it,”
as quickly as possible.”

Large orders for lime juice suggest that
scurvy was present in General Washington’s
army in the spring of 1778. Dysenterylike
conditions were also being encountered, but
the greatest burden on the entire hospital
system in the Middle Department during
the period spent at Valley Forge seems to
have resulted from the repetition of the
previous winter’s smallpox immunization
campaign. It was believed that not only
the ever-present possibility of action but also
the heat itself made the procedure inad-
visable in the summer, so despite the fact
that spring inoculation slowed the prepara-
tion of the army for a new season of cam-
paigning, the step was again undertaken in
the winter and early spring of 1778. At-
tempts to determine how many men would
require immunization began late in 1777,
and by January, the effort to inoculate all
susceptible soldiers in General Washington’s
army was under way. The progress was
slowed, however, both by the tendency for
some surgeons to slip away from camp and
by the lack of straw to serve as bedding.
By March, inoculation had progressed to
the point where, along with the lack of
proper clothing, it was rated as one of the
principal factors which “certainly emaciate
the effective column in our returns,” 2¢ and
the rate of sickness for General Washing-
ton’s army exceeded 48 percent.

Recruits for General Washington’s army
who had to come through Virginia were for
a time inoculated at Alexandria, Virginia,
under the supervision of Dr. William Rick-
man, Director of the Continental hospitals
in Virginia. In the fall of 1777, however,
rumors began to circulate that the procedure
was being mishandled there and that pa-
tients were dying with putrid fever. Rickman
was temporarily recalled, but the committee
Despair and Hope: June 1777-June 1778 85

 

VALLEY ForGE HospiTaL HUT. (Courtesy

investigating his conduct determined that the
high death rate was attributable to the
poorly clothed and exhausted condition in
which the men arrived at his hospital and
that the doctor had done as well as could
have been expected under the circum-
stances. 27

In March, it was decided that in the
future troops coming in from the south
should not be inoculated until they reached
the Valley Forge area. Orders were issued
to the effect that as they moved north,
these troops should avoid all towns where
smallpox might be present. In anticipation
of the inoculation of these men and ap-
parently believing it a necessary ingredient
of the diet of the smallpox patient, Cochran
urged that Potts send him “Molasses in
abundance.” By the end of April, approxi-

of Historical Society of Pennsylvania.)

mately one thousand men were in various
stages of inoculation at Valley Forge and
50 to 100 more were undergoing the pro-
cedure in a hospital near Wilmington, Dela-
ware.28

It is in the documents dating from the
winter at Valley Forge that one first en-
counters with any frequency the use of the
term “flying hospital” in connection with
the Continental Army. Like so many other
designations in this army, however, the
phrase was casually and imprecisely em-
ployed. In this instance, the flying hospital
was managed not in the British manner as
part of the general hospital (see Chapter 1)
but rather as a large and more formal ver-
sion of the regimental hospital. The flying
hospital at Valley Forge consisted of a
series of brigade hospital huts whose man
86 THE ARMY MEDICAL DEPARTMENT,

1775-1818

 

ScHOOLHOUSE USED As HosPITAL AT VALLEY FORGE. (Courtesy of Historical Society of
Pennsylvania.)

agement was the responsibility of Physician
and Surgeon General of the Army Cochran.
In these units were kept, as was the custom
also with regimental hospitals, only those
who would be ready in a short time to
return to duty and those who would be
moved to a general hospital as soon as their
conditions permitted.??

General Washington issued the order
which led to the establishment of the Val-
ley Forge flying hospital early in January.
He required his generals to have two huts
built for each brigade at appropriate loca-
tions 100 to 300 yards to the rear as soon
as men could be spared for the work from
constructing shelters for the rest of the army.
These hospital huts were to be 15 feet
wide, 25 feet long, and at least 9 feet
high. They were to be covered with board or
shingles, the cracks were to be left unfilled

in the interests of ventilation, and there
were to be a chimney at one end and a
window on each side.3?

General Washington wanted patients to
be kept as close as possible to camp, which
necessitated the opening of new units near
Valley Forge, for which the Hospital De-
partment at that time had “neither utensils
nor necessities required to open new ones.”
Nearby buildings, therefore, including
churches, barns, and even a schoolhouse,
were pressed into service to house Valley
Forge patients who could not be accommo-
dated in brigade huts. The assignment of
the individual patient to a hospital was al-
ways to be made by Cochran. General Wash-
ington pointed out that sending men to
overcrowded hospitals or to units not pre-
pared to receive them could have already
caused some deaths.?!
Ch. 4]

A lack of discipline among army doctors
continued to plague the hospital system at
Valley Forge. Although there were more
than sixty surgeons and thirty-three mates
serving with General Washington’s army
shortly before it entered winter camp, it
was difficult to estimate the exact number
actually on duty at Valley Forge because so
many were able to wangle furloughs to
which they were not entitled. At one point,
the general forbade all leave for doctors, and
in April, he ruled that only passes signed
by Cochran were to be honored. In an
attempt to further ensure that the sick of
his army receive as nearly adequate care
as was possible under the circumstances,
General Washington also ordered the com-
manding officer of each brigade to appoint
a captain to make daily visits to the sick of
his unit who were hospitalized in the vicinity
of Valley Forge.??

The casual attitude of so many Valley
Forge physicians toward their responsibili-
ties even thwarted General Washington’s
attempts to estimate the strength of his
army. The reports of hospital surgeons on
the number of men being cared for in their
facilities differed markedly from those of
regimental surgeons who were, despite the
general’s efforts, still careless, both in meet-
ing the deadlines which had been set for
their reports and in clearing hospitaliza-
tions with Cochran.??

By spring it was necessary to prepare
the flying hospital for the new campaign
season. Although the army was “becoming
more sickly,” the flying hospital itself was
reported by Craik to be “in fine order.”
General Washington's principal concern in
this connection seems to have been the
speed with which the staff of the flying hos-
pital could move the wounded after a battle
back to a general hospital, since he did not
wish to be again encumbered with disabled
soldiers while his army was on the march.
He therefore ordered the physicians of that
unit to investigate the most efficient ways

Despair and Hope: June 1777-June 1778 87

to move the seriously ill or wounded to
permanent facilities, and by the end of June,
approximately 85 percent of those under the
care of surgeons appear to have been trans-
ferred to general hospitals.

During the winter of 1777-78, patients
from the camp too ill to remain in the flying
hospital were cared for in the general hos-
pitals nearest Valley Forge, while facilities
at a greater distance sheltered the sick and
wounded hospitalized during the fall’s cam-
paigns. In the first group, the Yellow Springs
facility was by far the largest and most im-
portant. It was built during the early winter
on land owned by an army physician, Dr.
Samuel Kennedy, in an area already well
known for the healing properties of its min-
eral spring.??

Unlike so many of the army’s hospitals
during this period, the Yellow Springs unit
was carefully planned from the outset. The
main building, later called Washington Hall,
was specifically designed for the purpose and
could comfortably shelter 125 patients. It
was three stories and an attic high, 106 by
36 feet in dimension. The first floor held the
kitchen, dining room, and service rooms, the
second two large wards, and the third many
small rooms. Nine-foot porches extended
around three sides of the first two stories.
Dr. Bodo Otto, formerly in charge of the
Trenton hospital, was called to take over
here, where he was joined by at least two
of his sons and by Kennedy himself.3¢

Although Otto’s patients began to arrive
before the new building was ready for use
and thus had to be sheltered in three near-
by barns, the Yellow Springs unit quickly
acquired a reputation for being “very neat,
and the sick comfortably provided” for.?7
General Washington himself visited the hos-
pital in May, speaking “to every person in
their bunks, which exceedingly pleased the
sick,” and was apparently favorably im-
pressed by the facility.?$

Nevertheless, the Yellow Springs unit was
not without its problems. Putrid fever raged
88 THE ARMY

WASHINGTON HALL. (From James E. Gibson,
the American Revolution, 1937. Courtesy
11.)

there as elsewhere, and Kennedy, among
others, died from it. The staff found that a
shortage of the wine so esteemed for its
medicinal properties triggered problems with
rowdy officers who “crowd in upon us and
from the reputation of our hospitals, . . .
call for wine and threaten excision if they
do not get it.” Furthermore, the number of
patients was so great that other nearby
buildings were pressed into service, the three
barns were retained in use even after the
main building was opened, and a conva-
lescent unit was opened about two miles
distant from Washington Hall.3?

Among the units caring for battle casual-
ties was the hospital reopened in Bethlehem,
Pennsylvania, in September. At the end of
November, Shippen recorded only 383 pa-
tients at this facility, but patients continued
to arrive in the village throughout December.
(See Table 6.) The total number of the
sick and wounded in the Bethlehem Single
Brethren’s House alone by the end of De-

MEDICAL DEPARTMENT,

1775-18138

 

Dr. Bodo Otto and the Medical Background of
of Charles C Thomas, Publisher, Springfield,

cember, after the arrival of fifty wagons
laden with men from New Jersey on the
27th, was reported to be over 700. Many of
these patients arrived after exhausting jour-
neys through snow and rain clad “in rags
swarming with vermin” and despite the
Moravians’ efforts to collect blankets,
bandaging, and clothing on their behalf, con-
tinued even in the hospital to be poorly
clothed and filthy. In this environment, of
course, wounds quickly became infected
and putrid fever appeared. It spread rapidly
not only among patients but also among
attendants, many of whom were Moravi-
ans,*” and afflicted most heavily those on
the upper floor, where “the stench and filth
were bad indeed.” The Reverend John
Ettwein wrote in his account of the 1777-78
winter that among the Moravians, “several
died (among them my best & dearest Son
20 Years old).” 4

Preparation to close the Bethlehem hos-
pital began in the spring of 1778, and in
Ch. 4]

a ¢ a

BRETHREN’S HOUSE AT Lititz. (Courtesy

mid-April, a large number of the patients,
about 100 of whom were classified as con-
valescents, were removed to the facilities
at Lititz, Pennsylvania. A few still remained
in Bethlehem in early May, however, and
it was not until late June that the Moravian
men were able to reoccupy their home. The
staff of this hospital was moved to the Yel-
low Springs area to serve patients left be-
hind at Valley Forge.*

The village of Lititz, to which so many
Bethlehem patients were taken in April
1778, was a Moravian community about
half the size of Bethlehem. Since here, too,
the order possessed large buildings appropri-
ate for hospital use, when hospitals near

Despair and Hope: June 1777-June 1778

i» » Vn

Fa cn : » ; ow 1 .
Canara . - ? TL.
; PL TR TERY + at

 

oi ah

of Historical Society of Pennsylvania.)

Philadelphia were being evacuated, a unit
was cstablished in the stone Brethren’s
House, which was three stories high, 60
feet long, and 37 feet wide. Dr. Samuel
Kennedy was in charge of the Lititz unit
from the time of the unit's opening until
he moved to Yellow Springs, when he was
succeeded by Dr. Henry Latimer. Dr. Wil-
liam Brown, best known as the probable
author of the first American pharmacopoeia,
made Lititz his headquarters after his selec-
tion as Physician General in February
1778.43

The hospital at Lititz, apparently over-
crowded soon after its opening, was also
swept by disease during the winter of
90

   

BROTHERS’ HOUSE AT EPHRATA.

1777-78. Although the first cighty patients
arrived in fifteen wagons on the evening of
19 December, only two days later the unit
had become so crowded that its staff had to
turn away 100 patients. Inevitably, in a
very short time, putrid fever was raging.
The hospital quickly ran out of medicine
and members of the staff began to fall ill.
In a ten-day period ending 1 January 1778,
seven patients died. From 12 to 22 Janu-
ary 1778, there were 12 deaths and 25
cases of putrid fever among the 173 pa-
tients. In the course of the winter, both of
the physicians serving the hospital contracted
the disease at the same time, and civilian
doctors had to be called in to care tempo-
rarily for military patients. Five Moravian
nursing volunteers and the congregation’s
pastor died. The Sisters’ House Diary of
Lititz records in an entry at the end of
December, “The misery of the lazaretto

THE ARMY MEDICAL DEPARTMENT,

1775-1818

NE YW

Na
MN IN Se a,

  

(From Duncan, Medical Men.)

cannot be described; neither can it, without
being seen, be imagined.” #4

The town of Ephrata, where a Hospital
Department unit opened about the time of
the Brandywine engagement, was another
unusual religious community, not of Mora-
vians, however, but of “Dunkards,” after
whom Ephrata was also called Dunkerstown.
The Dunkards of Ephrata were actually a
splinter from the original Dunkards, lived
celibate and almost monastic lives, and ob-
served the seventh day of the week as the
Sabbath. At Ephrata, three surgeons and
two mates apparently formed the staff which,
during the course of the winter and spring,
cared for about 500 patients. Although the
buildings they used were relatively large,
the Dunkards of Ephrata had made their
rooms small and the doorways low, in an
attempt to keep the occupants humble. *3

The community kept the hospital well
Ch. 4]

supplied with veal and milk, and Shippen
sent in all the required medicines, while
the physicians in charge reportedly main-
tained a high level of discipline; but the
death rate was still high. Putrid fever soon
invaded this unit, too, and killed patients,
staff, and Dunkards who had volunteered to
serve as nurses. As many as 200 were
rumored to have died and been buried on
a hill in a plot belonging to the community,
but Brig. Gen. Lachlan McIntosh reported
that from 18 December 1777 to 26 April
1778, only 57 either died or deserted and
168 were discharged, with 34 remaining in
the hospital as of that date.*®

Ephrata was considered at the time to
be “An inconvenient place for an Hospital,”
but an unknown number of the patients
from the facility at Reamstown, Pennsyl-
vania, were moved there, nevertheless, on
17 March 1778, when the Reamstown unit
was closed. By June 1778, however, the
Ephrata hospital, too, had been closed.*”

Another important Pennsylvania hospital
during this period was at Reading, often for
patients whose ultimate destination lay
further to the west. Beginning in September
1777, the courthouse, a potter’s shop, sev-
eral churches, a Quaker meetinghouse, and
other buildings in Reading were used to
shelter patients. Soldiers’ wives were among
the patients here and as many as eight of the
nurses were women. These buildings quick-
ly filled up and as early as mid-December
men were being sent on to other hospitals,
including that at Ephrata. On 30 March,
149 patients were reported to be at the
Reading facilities, but by mid-April, only
32 remained. General McIntosh recorded a
total of 132 as dead or deserted in the
seven months of the hospital's operations
to that date, 367 sent on to Lancaster
County hospitals, 22 furloughed, and 513
more returned to camp. *$

Other large general hospitals in Pennsyl-
vania at this time included the units at
Allentown and Easton. In November 1777,

Despair and Hope: June 1777-June 1778 91

the Allentown facility held 190 men and
that at Easton 400, but by March 1778,
the two together held no more than 70
patients and were plagued by shortages,
especially by a shortage of beef. Shippen,
on visiting these hospitals in the spring,
urged that both be closed and that any
patients not ready to return to camp be
sent to Bethlehem. The men at Easton were
moved to Bethlehem on 27 March, but the
unit at Allentown remained open through
mid-April 4

The idea that the military hospitals in
the Middle Department should be consoli-
dated was put forward in the spring of
1778 by both Shippen and General Mcln-
tosh, who made an inspection trip among
these hospitals at this time at General Wash-
ington’s request. Both men envisioned a
greater concentration of patients at the
Lititz unit, to which General McIntosh
recommended the removal of the Schaef-
ferstown and Ephrata patients. He urged
that all Pennsylvania hospitals except those
in Lancaster County (which included the
Lititz unit) be closed. Shippen, however,
wished to go further and envisioned the
expansion of the Lititz facility and the com-
plete abandonment of the village by the
Moravians. The Reverend Ettwein, however,
wrote General Washington to emphasize
that his people from Lititz would be ren-
dered almost incapable of supporting them-
selves should this happen. Shippen finally
abandoned his plan, but the Hospital De-
partment continued to occupy the Brethren’s
House there for five more months and pa-
tients continued to come into Lititz not only
from Bethlehem but also from Easton, Al-
lentown, and Reading, as the hospitals in
these towns were closed.”

In addition to the hospitals in Pennsyl-
vania, at least two units east of Philadelphia
remained open during the winter and early
spring, one at Princeton and the other in
Delaware. The latter facility averaged eighty
patients, all from Brig. Gen. William Small-
92 THE ARMY MEDICAL DEPARTMENT,

wood’s brigade. Originally located at New-
port, which Gencral Washington considered
to be too exposed, this hospital was moved
to the Nottingham Meeting House near Wil-
mington some time shortly before 22 April
1778. The Princeton hospital, the only one
outside of Lancaster County, Pennsylvania,
which General McIntosh believed should
remain open in the Middle Department, held
only fifty-three patients as of 8 April. From
14 January to 8 April, 52 died or deserted
from this hospital, while 135 were recorded
as returned to duty.®!

As spring approached, various proposals
were put forth concerning the handling of
the casualties which would be left behind
when the army marched or would be sent
to the general hospitals from the flying hos-
pital with General Washington’s army.
Craik at one time envisioned continuing to
use the huts at Valley Forge as units of the
general hospital after the army itself had
left. He assumed that 1,500 to 1,700 pa-
tients would be left behind and urged that
Shippen send surgeons and mates to Valley
Forge to care for them since, of course, the
regimental surgeons would leave with their
units.52

General Washington, however, was not
happy with the use of these huts even for
healthy men and had ordered some sickly
regiments to vacate their huts as soon as
tents could be obtained for them. The rate
of illness continued to climb at this critical
time, however, and there were not enough
wagons available to move the ill to hospitals
beyond Valley Forge. The general seemed to
have at last resigned himself to the tempo-
rary use of huts for the sick, but he ordered
that any mud used as plastering be removed
and every effort be taken to improve venti-
lation.®3

The general also ordered that officers be
appointed to stay behind with the ill at
the rate of one officer for every 250 men.
He told his regimental surgeons to report
to Cochran on the number of men who

1775-1818

could not march with the army and required
that medical attendants from each brigade
remain to care for these men until hospital
surgeons could remove them. An attempt
was also to be made to find women to serve
as nurses for the patients remaining at Val-
ley Forge. On 1 June, General Washington
appointed a colonel to supervise the care
of the sick and to send them back to the
army as they recovered. Finally it was de-
cided to put Otto in charge of the patients
left behind and to move them when possible
cither to Yellow Springs or to a new hos-
pital to be established for them elsewhere.5*

On 18 June, the British evacuated Phila-
delphia and General Washington led his
army out of Valley Forge to reoccupy that
city and then through Bucks County, Penn-
sylvania, across the Delaware River; on 28
June, the army was into the first action of
the new season, at Monmouth, New Jer-
sey.%s

THE NORTHERN DEPARTMENT

Although the men under Maj. Gen. Philip
Schuyler, like General Washington’s men,
continued to suffer from a lack of clothing,
prospects for the new season of campaigning
seemed reasonably bright as far as the
army’s health was concerned. The smallpox
problem was under control, and newly
planted gardens promised a reliable supply
of fresh vegetables. The total number who
were sick of the 4,533 men who were at
Ticonderoga and Mount Independence on
25 June, however, is difficult to estimate.
(Map 5) Samuel Adams reported 342 to
be “Sick in camp, and in barricks” as of
that date,” and since General Schuyler
complained of the hospital under construc-
tion there that “not one single room .

is yet finished, nor will it soon be in condi-
tion to receive a considerable number of
sick,” °7 one might safely assume that there
were few patients, if any, being cared for
outside of “camp . . . and barricks,” in this
area. It is, therefore, surprising to note that
Ch. 4] Despair and Hope: June 1777-June 1778 93

 

 
   
 

Montreal C J

CANADA

MAINE
\ (part of Mass.)

   

VERMONT

Lake Champlain (disputed claim)

       
  

Crown
Point
"n Mount
|

Zz
~ Independence

Fort 2 >

S
>
§
<
$
Ticonderoga $
S

  

Skenesboro

Fort x XH Fort

George Anne

HAMPSHIRE

 
 
 
     
 
 
 

  

Saratoga

 
 
 
  

Bennington
Schenectady
oO

Q

Albany

     

MASSACHUSETTS "7,

 
    

 
  

ee et) J i
Providence

   
   
  

Hartford
Oo

 
 

 

CONNECTICUT

| Danbury
O

Q .
Peekskill
7

 

Fishkill

  
 

    

Norwa

 

 
94 THE ARMY MEDICAL DEPARTMENT,

 

JAMES THACHER. (Courtesy of National Li-
brary of Medicine.)

in the entire Northern Department in July
and August the overall sick rate, if monthly
report figures are used, was just under 24
percent and that more than half of these
were “sick absent.” General Schuyler was
distressed by the condition of the hospital
accommodations on Lake Champlain and at
the end of June had all the patients not
likely to be ready to return to duty in a
very short time moved in covered boats
to the Fort George facilities where, he be-
lieved, there would also be a better supply
of vegetables.”®

The British, under Maj. Gen. John Bur-
goyne, had already begun their move south,
and when, on 6 July, Continental forces
abandoned Ticonderoga, the remaining pa-
tients, along with hospital and other supplies,
were hastily loaded into 200 small boats.
That night, escorted by five armed galleys
and a guard of 600 men, these vessels
slipped across thirty miles of water as still

1775-1818

as glass to Skenesboro, at the southern tip
of the lake. They were so closcly pursued
by the enemy, however, that they were un-
able to stop there and were forced to con-
tinue south along a small river to Fort Anne,
in the process losing to the British several
patients and most of their supplies. At Fort
Anne, the sick were placed in tents where
they remained until 25 July, when surgeon’s
mate James Thacher was ordered to take
them by boat to Albany. Thacher and his
forty patients arrived there safely, having
covered approximately fifty-five miles in
three days.’® On 29 July, the British also
took Fort George. If any of the patients who
had been moved to Fort George from Ti-
conderoga were still there, presumably they
also moved farther to the south before the
British arrived.

Although the hospitals in the Lake Cham-
plain-Lake George area were abandoned in
the summer of 1777, a new unit was estab-
lished at roughly the same time in the vicini-
ty of Bennington, Vermont, to serve the
militia units gathering there. American pa-
tients were cared for by regimental surgeons
in whatever shelters could be found for them
scattered about the countryside, but after
the British were severely defeated in their
raid on Bennington, Dr. Francis Hagan
reported to Potts that a meetinghouse had
been taken over for wounded prisoners and
two German surgeons had been placed in
charge of them. Stores were badly needed;
this shortage was to continue throughout the
summer and fall, causing unnecessary suf-
fering for the unit's patients. Hagan could
not find nurses for the wounded, and the
local population was of no assistance to
him, but his patients were in no condition
to be moved. The situation here seems to
have only deteriorated as the scason pro-
gressed, for as late as 21 September, Hagan
was writing Potts of his fear of the effects
of cold weather upon his patients, of the
poor condition of the prisoners, and of the
additional problem posed by the fact that
Ch. 4]

the British and Hessian patients were mu-
tually antagonistic.®?

Not all was gloomy at Bennington, how-
ever. Another physician there, Dr. Samuel
MacKenzie, wrote Potts on 27 August 1777,
“I want Doctr Treat here very much to
prescribe leeks for the Doctrs as they seem
very fond of bundling and the Tory girls
seem to have no objection to that kind of
amusement.” ©!

The flying hospital for the Continental
Army in the Northern Department, under
the direction of Physician and Surgeon Gen-
eral of the Army John Bartlett, was also
beset by many problems. Its location as the
army prepared to meet General Burgoyne
at Saratoga was considered unhealthy, and
at times the sick entering and being dis-
charged were too numerous to count, al-
though on 18 August, Bartlett fixed the
number of patients at 335, under the care
of thirty-two nurses. Regimental surgeons
contributed to the situation by complaining
that Bartlett was refusing to supply them
with medicines, lint, and bandages, a charge
he vigorously denied. His staff was too small,
he added, and he needed three more regi-
mental surgeons and three more mates. By
the end of the month, when he still had
192 patients in his hospital, such regimental
surgeons as were available were refusing to
help him, saying that Maj. Gen. Horatio
Gates, who replaced General Schuyler on
19 August, had forbidden them to do so.%?

Despite the good beginning, as the sum-
mer progressed, sickness increased in the
Northern Army. The men were often in
retreat, at times without shelter, and almost
always short of every sort of supplies except
food, and the quality of that food was open
to criticism. Nevertheless, on 20 July 1777,
of 6,023 officers and men, only 459 were
reported to be in the general hospital, a
figure which apparently represented about
half of the total list of those sick and pre-
sented a marked contrast to the situation in
the North the previous year. The staff of

Despair and Hope: June 1777-June 1778 95

the department included fifteen surgeons
and seven mates and the much feared putrid
fever was not a great threat. Furthermore,
during the period 1 March to 29 August
1777, only fifty-three of the men cared for
by these doctors were reported to have
died.%3

General Gates’s force grew rapidly in
October 1777. He had approximately 8,000
officers and men on 4 October, 885 of
whom were sick in the general hospital and
another 4,000 men joined him in the course
of the following three days. In contrast to
the situation which developed in the North
in the spring of 1776, however, the staff of
the Hospital Department in the Saratoga
area, responsible for both American patients
and wounded prisoners, also grew rapidly
until it was almost double its original size.
From the end of August to mid-November
1777, however, another 150 men were re-
ported to have died and the British com-
plained that their wounded held by the.
Continental Army were not being well
treated. In September, British Brig. Gen.
Simon Fraser himself inquired with concern
about sick and wounded prisoners in Ameri-
can hands after the British raid on Benning-
ton and suggested that he could forward
both medicines and surgeons to aid in their
care, but General Gates appeared initially
to have rejected this offer. The American
informed his counterpart that his wounded
prisoners were well supplied with “Surgeons,
medicines, and attendance, with every com-
fort imaginable.” After their Saratoga defeat
in October, however, when the British were
forced to abandon an entire hospital, includ-
ing approximately 250 patients, five medical
attendants remained with their patients in
captivity.%*

At some time in the fall, the British
wounded were moved from the Saratoga
area to the Albany facilities, where more
than 300 American patients were being
cared for, but their chief physician contin-
ued to complain of the treatment they re-
96 THE ARMY MEDICAL DEPARTMENT,

ceived and of supply shortages. Among the
enemy patients here who had the least cause
for complaint, however, was one Maj. John
Dyke Ackland (Acland), who was shot
through both legs. His wife, who had accom-
panied him through the entire campaign,
sailed down the Hudson River, accom-
panied only by a maid, a valet, and a
chaplain, to join her husband at Albany and
to nurse him back to health at the hospital.
She apparently was treated with true gal-
lantry by General Gates.®®

Most of the American patients at the
Albany hospital suffered from disease rather
than from physical injuries; numbers of
patients reported in mid-August were as
follows:

Dysentery 81 Rupture 2
Intermittent fever 79  Scorbutic 4
Diarrhea 61  Pleurisy 3
Rheumatism 22 Hemorrhoid 1
Cough 25 Hemoptysis 2
Convalescent 17 Nephritis 3
Debility 17 Asthma 1
Lues venerea 14 Paralysis 2
Fever 13 Cholera 1
Whooping cough 10 Hypochondria 1
Head itch 9 Scrofula 3
Measles 8 Ophthalmia 1
Putrid fever 6

Bilious fever 4 Total 396
Dropsy 4

Jaundice 2 Surgical 53
SOURCE: A Return of the Present State of the General

Hospital at Abany [sic] 20 Aug 1777, Potts Papers,
2: 283. This return, however, gives an incorrect total
of 296.

In the fall of 1777 the patients with phys-
ical injuries included none other than Brig.
Gen. Benedict Arnold (promoted to major
general on 29 November 1777), who was
again wounded, this time by a musket ball
which had broken his leg. Of Arnold the
patient, Thacher said, “He is very peevish
and impatient under his misfortunes.” Hos-
pitalized for a time with Arnold was a
young lieutenant colonel, James Wilkinson.
who was to lead a colorful life after the
Revolution and to serve with less than com-

1775-1818

plete success as a major general in the War
of 1812. While on duty in the North,
Colonel Wilkinson became so ill that he had
to be evacuated by wagon first to Albany
and then, on 20 October, accompanied by
a hospital surgeon, further south, taking with
him the details of the Saratoga victory.®®

By the end of October, the overflow from
the main Albany unit had spilled over into
private homes and a church. Enemy pa-
tients were being cared for by their own sur-
geons, but Thacher considered the Hessian
doctors “uncouth and clumsy operators.”
The operations being performed consisted
principally of amputations and trepanning,
and some surgical patients for a time had to
endure maggots which thrived in their
wounds. Among the twenty patients Potts
had assigned to Thacher was a particularly
interesting one in the person of an American
captain who had managed to survive a
scalping at the hands of the Indians.®?

The increase in the number of patients at
the Albany unit strained the supply system
in the Northern Department. For a time,
no fresh straw was available, and with the
harsh northern winter rapidly approaching,
wood was also badly needed. In an attempt
to relieve the pressure on the hospital, seven-
ty to eighty men were returned to their bar-
racks and steps taken to furlough an even
greater number. By mid-November, how-
ever, 218 patients, 118 wounded and 100
sick, were still listed on the rolls at the
Albany hospital, a figure which a month
later had risen to a total of 297.98

The number of patients under the care
of Dr. Dirk Van Ingen in Schenectady had
also increased in this period to the point
where by late summer Van Ingen had found
it necessary to hire two men and two women
to care for them in the two rooms which
had been allotted them in a barracks. By
mid-August, he needed bedding, medicines,
and more attendants for his forty-three pa-
tients. In November the Schenectady unit was
treating 72 patients and a month later 312,
Ch. 4]

more than were reported for that period by
the Albany unit. The subsequent decrease
in the patient load by February 1778 led to
the transfer of remaining Schenectady pa-
tients to Albany, where on 16 February 1778
there were only 304 patients, 24 of whom
were children being wormed. (The records
do not indicate whether these patients were
military dependents.) %°

Inoculation continued to be practiced in
the Northern Department, although the evi-
dence suggests that the procedure was un-
dertaken earlier in the year in the North
than it was in the Middle Department. Re-
peated references to the fact that inoculation
was taking place can be found, but since
the records remaining to us from this period
rarely distinguish between smallpox deliber-
ately and naturally acquired, we can only
assume that most of the smallpox patients
hospitalized in the Northern Department at
this time had acquired the disease through
deliberate immunization. Northern Depart-
ment records list 68 smallpox patients at
Albany and 260 at Schenectady in Decem-
ber 1777, but only 30 at Albany and 55 at
Schenectady in January, and on 15 January,
Dr. Robert Johnston noted that those pa-
tients who had been inoculated had done
well and were almost ready to return to
duty.

The total number of patients in the
Northern Department at the end of Novem-
ber was estimated by Director General Ship-
pen at 1,000. Potts had been forced by ill
health to return to Pennsylvania at the end
of the campaign season and Johnston was
asked by both General Gates and Potts to
function as Deputy Director General in the
Northern Department, although it appears
that he was never actually named to the
position. By the end of the year, since the
patient load was diminishing and all of the
twenty patients assigned specifically to
Thacher’s care had recovered, the young
surgeon was permitted to go on a forty-day
furlough.”

Despair and Hope: June 1777-June 1778 97

When Thacher returned in February
1778, although the hospital was in desper-
ate need of money, the atmosphere was
quite different from that prevailing in Mid-
dle Department hospitals at this time. ““Sev-
eral gentlemen belonging to the hospital
being desirous of improving in the accom-
plishment of dancing,” Thacher and his
friends actually hired a teacher and every
afternoon worked with him to prepare them-
selves to “figure in a ballroom.” In the
spring of 1778, with the patient load still
steadily decreasing, the decision was made
to move most of the Albany staff and sup-
plies down the Hudson to the West Point
area, since it was expected that in the future
major Continental operations would not
take place in the Northern Department. On
5 June, therefore, the staff, except for three
doctors who stayed behind to care for the
remaining patients, and the facility’s stores
were embarked on a sloop and taken down
the Hudson. Two days after its departure,
the unit stopped at Fishkill to replenish its
food supply and on 10 June was ready to
install itself on the east bank of the Hudson
across from West Point. Large houses sur-
rounded by extensive farms and gardens
had been found for the hospital facilities to
be established there; good pasture for horses
and cows abounded, and a number of large
orchards offered several kinds of fruit. The
principal house used by the Hospital Depart-
ment here was referred to as Robinson’s
House, after the wealthy Tory Col. Beverly
Robinson, from whom it was confiscated
following his flight to New York City."

THE EASTERN DEPARTMENT

Despite several British raids in the area,
there was no major action in the department
east of the Hudson River in the period June
1777 to June 1778, and there were few pa-
tients for Eastern Department hospitals to
treat, only 383 being reported there in late
November 1777. Dr. Isaac Foster had been
placed in charge of this department in April
98 THE ARMY MEDICAL DEPARTMENT,

 

PHILIP TURNER. (From Packard, History, I:
565; reproduced from Charles B. Graves,
“Dr. Philip Turner of Norwich, Connecti-
cut.” Annals of Medical History 10 (1928).
Courtesy of Harper & Row, Publishers,
Inc.)

1777 with physicians Ammi Ruhamah Cut-
ter and Philip Turner as his Physician Gen-
eral and his Surgeon General, respectively,
and Dr. William Burnet as his Physician and
Surgeon General of the Army. Cutter ap-
parently resigned his position in March
1778.73

The hospitals within this department in-
cluded units at Danbury, to which the Stam-
ford hospital had been moved, Hartford
and New London, Connecticut, Providence
and Newport, Rhode Island, Boston, Mas-
sachusetts, and Fishkill and Peekskill, New
York. The assignment of patients to ap-
propriate hospitals was the responsibility of
Burnet, who also received reports from regi-
mental surgeons reputed to be often careless
with their reporting. Turner apparently
made his headquarters at Danbury, where a

1775-1818

five-room building housed the hospital, and
traveled a 400-mile circuit to visit lesser
units. 7

The hospitals in his department, Foster
maintained, were in excellent condition and
“the sick soldiers are as anxious this year,
to be admitted into them, as they were last,
to avoid them.” Rush believed Foster’s
division to be so superabundantly supplied
with linen, bedding, and similar items that
he suggested that the Director General send
someone to New England to bring back a
portion of their plenty to the Middle De-
partment.”

The only real concern for the medical staff
of the Eastern Department lay in the possi-
bility of a smallpox epidemic among newly
arrived troops during the active part of the
campaign season, since, as noted in the sec-
tion on health at Valley Forge, inoculation
was not undertaken during the summer. As
early as July 1777, therefore, Maj. Gen.
Israel Putnam, commanding in the Peekskill,
New York, area, ordered the immediate hos-
pitalization and isolation of all who so much
as seemed to be infected with the disease.
Inoculation was undertaken in the late winter
and early spring of 1778, however, and the
existing records do not mention any type of
epidemic in this department in the period
June 1777 to June 1778. Foster was able to
comment in March 1778 that “we do very
little here.” 76

The 1777-78 season was characterized by
inactivity in the Eastern Department and the
end of large-scale operations in the North,
but the Hospital Department had no reason
to expect that their work would be easier in
the 1778-79 season. The Continental doctors
and their patients from General Washing-
ton’s army had endured another year of
agony, and the sickly condition of the men
as they left Valley Forge gave little reason
for optimism.
From Defeat to Victory, June 1778 to 1783

For three years after the battle of Mon-
mouth in June 1778, the major operations
of the Continental Army took place in the
South, where the organization of the Hos-
pital Department was either weak or non-
existent. The successful siege of British-held
Yorktown, Virginia, by a combined French-
Continental force in the early autumn of
1781, however, brought an end to all sig-
nificant military activity in the American
Revolution, while the signing of the Treaty
of Paris in the early autumn of 1783 was
followed by the disbanding of both the
Continental Army and its Hospital Depart-
ment.

NORTH OF THE PoToMAC:
BEFORE THE VICTORY
AT YORKTOWN

After evacuating Philadelphia in June 1778,
the British forces withdrew to New York
City, on their way defeating an attempt by
the Americans to stop them at Monmouth,
New Jersey. (Map 6) After the battle of
Monmouth, General Washington also led
his men north and established his head-
quarters at White Plains, New York. Gen-
eral Washington’s army saw little action
in the North from this point onward,! and
the number of wounded was correspondingly
small, but shortages of food, clothing, and
supplies continued to have an unfavorable
effect upon both the health of the army and
the suffering of the patients in Continental
hospitals.

The wounded from the battle at Mon-
mouth were initially cared for in nearby

buildings, including a courthouse and
churches, where they lay upon straw on the
floor. Many fell victim to the heat during
the battle, and as the army continued
northward, the number of those unable to
keep up the pace without medical care in-
creased, the temperatures being so high
that a “vast number of our men fell down
with the Heat . . . & Died.” Early in July,
General Washington, concerned lest the
army’s mobility be impeded by attempts to
carry the sick and wounded with it, ordered
that they be sent to a barracks in the town
of Brunswick, New Jersey, and that the
director of the flying hospital inform him at
once how many of these men were left
behind. Many who became ill after early
July appear to have been carried along for
a short time in wagons but at the end of
the month were sent back to hospitals at
Trenton and Princeton, New Jersey. It ap-
pears that somewhere in the course of the
march to White Plains, men were also hos-
pitalized at Springfield, New Jersey, in ac-
commodations General Washington con-
sidered inadequate. Only one Hospital De-
partment physician could be spared for this
facility, but a regimental surgeon was as-
signed to assist him. The number of patients
here rose to 200 before these men could be
moved to the hospital opened at Morris-
town, New Jersey.?

In returning to New York State, General
Washington’s men crossed from the Middle
into the Eastern Department, where Dr.
Isaac Foster was the Deputy Director and
Dr. William Burnet the Physician and Sur-
100 THE ARMY MEDIcAL DEPARTMENT, 1775-1818

 

NORTHERN
bo DEPARTMENT

NEW YORK

Hudson R

%
YO, oy New Hackensack
2,
2

O
CP New
Windsor (2, iy
otterkill op ©
West Point QO)
Robinson House {{~

  
 
  
    
  
  
  
  
  
  
   
   

 

Q ~
o & Ne Peek ski
@ ~ ;
MIDDLE &* “Jaw
Se O
DEPARTMENT Paramus
Jockey
Morristown Hollow
Z OS
Sunbury PENNSYLVANIA Basking Ridge 5 Springtield D EW
A Y
0 (0 /YORK
Pluckemin Bound ITY
Middlebrook PK 4
Brunswick
{ Reading Princeton
\ © Schaefferstown 0
\ Yo §
\ “, enc Creek Trenton Monmouth
A 2 oO Yellow Springs

» Lititz
Downingtown

Zf
PHILADELPHIA

NEW JERSEY

   

 

MAP 6
Ch. 5]

Defeat to Victory: June 1778-1783 101

 

I
/

/

Danbury
O

Bedford
v

De cain ge

  

-

    
  
    
 

QO)

B0sTON A
MASSACHUSETTS
« Springfield
5 YO
¢] eastern T x
S rovidence |

O
Harford, DEPARTMENT RHODE

  
   
 
  

CONNECTICUT ISLANGRY

0 SF
New J
London 2
O 5
102

geon General of the Army. Dr. John Coch-
ran, however, was still attached to General
Washington's army as Physician and Sur-
geon General of the Army. The situation
was further complicated by the fact that
many surgeons from the Northern Depart-
ment were still working in this area. Rather
than grant either Cochran or Burnet su-
preme authority over flying and regimental
hospitals there, General Washington ordered
that they share the responsibility. Burnet
apparently signed many, if not all, of the
weekly returns submitted concerning these
facilities,® but there does not seem to have
been any friction betwcen the two men.
Reports of the late summer of 1778
signed by Burnet as Physician and Surgeon
General of General Washington’s army sug-
gest that the number of the sick within
General Washington's army was running at
1,200 to 1,450 men per week, but not all
of the sick soldiers were retained in the
hospitals within the camp and the monthly
strength report for the period indicates that
the rate may have been 17 to 20 percent.
On 12 September, a group of patients was
moved to the general hospital at Fishkill.
Water transportation was frequently re-
sorted to for such moves, many of the pa-
tients on this occasion going by land to
Tarrytown and thence by water to Fishkill.
Those able to walk went on foot to Peecks-
kill, where they boarded boats for the
same destination, while their packs were
sent separately by the Tarrytown route.*
Little detail is available on the manage-
ment of medical support for the unsuccessful
attempt by the Continental Army on New-
port, Rhode Island, conducted from 29
July to 31 August 1778, but we know that
the care of the 137 American wounded was
assigned to Dr. Thomas Tillotson of the
staff of the Northern Department and to an
assistant, also drawn from the Northern
Department staff. Tillotson reported to Fos-
ter, from whom he was ordered to obtain
his medicine, instruments, and “such things

THE ARMY MEDICAL DEPARTMENT,

1775-1818

as may be thought necessary in the forma-
tion of a military and flying hospital.” ©

When it was time in late 1778 to estab-
lish winter camp, several units remained be-
hind at Peekskill, Fishkill, and West Point,
New York, and three brigades wintered at
Danbury, Connecticut, but the bulk of Gen-
eral Washington’s army marched south to
winter camp at Middlebrook, New Jersey,
in late November. A total of seven brigades
spent the winter there, while an eighth
camped at Paramus, New Jersey. Informa-
tion on the precise nature of the hospital
facilities serving troops in New Jersey dur-
ing this winter is not plentiful, but it appears
that some patients were housed in nearby
churches, barns, and a courthouse, while
others were sent to the hospital at Bruns-
wick. There seem also to have been phy-
sicians caring for Middlebrook patients at
Bound Brook.®

There was remarkably little sickness in
the Continental Army north of Virginia in
the years 1779 and 1780, perhaps as a
combined result of inoculation for small-
pox, a drop in the proportion of green to
seasoned troops in the Army, and efforts
to improve sanitation and discipline. Since
the health of his army while it camped at
Middlebrook did not demand all the time
of the regimental surgeons there, General
Washington was able to decide that it
would be wise if they were to spend some
of it improving their professional knowledge
and skills. A series of lectures was planned,
with the first to be conducted by Dr. Wil-
liam Brown, Physician General of the Mid-
dle Department, in February. The general
observed that “All regimental surgeons are
desired to attend.” 7

In May 1779, General Washington led
his men out of winter camp toward West
Point, New York, after ordering that the
huts they had been using be left standing
for the benefit of those too ill to keep up
with their fellows. After the army reached
West Point, the number hospitalized with-
Ch. 5]

in the camp at any one time often ran
higher than 300, with 20 to 30 percent of
this number classified as convalescent. A
comparable number might be described as
lame. Well over 10 percent of the total in
the hospitals within the camp were suffering
from intermittent fevers, but putrid fever
does not seem to have been a serious threat
at this time.®

In the fall of 1779, Virginia and Carolina
troops were sent south toward their own
states, where enemy invasion was antici-
pated, and other units again camped for
the winter along the Hudson River or in
Connecticut, but the main body of the army
left the Highlands of the Hudson in late
November and arrived at the camp at Jock-
ey Hollow, about three miles south of Mor-
ristown, early in December.?

These men were already in poor condi-
tion and without adequate food, clothing,
or fuel, and now, since they were not using
the site of the 1776-77 encampment, there
were no huts available to house them when
they arrived. With the snow lying two feet
deep around them, they had to lie on the
bare earth. For more than a week after their
arrival at camp, there was no bread for
them to eat.!®

During the winter of 1779-80, rivers
froze solid and temperatures reportedly
dropped lower than they had been in
decades. The four to six feet of snow which
sometimes covered the ground interfered
with the transportation and delivery of sup-
plies and occasional thaws only turned
roads into quagmires. Food had been hard
to obtain even before the onset of winter
because the drought of the previous summer
had lowered both crop yields and the
level of the water which powered flour
mills. Now the frozen streams of winter
again made milling impossible and, for a
long period of time, adequate stocks of
clothing were still unavailable. By spring,
the army was near starvation and mutinies
were beginning to break out.!!

Defeat to Victory: June 1778-1783

103

Surprisingly, however, in view of the con-
ditions at the camp, there were relatively
few patients in the hospitals serving Morris-
town in the winter of 1779-80. In February
1780, approximately 3.5 percent of the
slightly more than 11,500 men at Morris-
town were reported seriously enough ill to
be hospitalized and perhaps more than twice
this number of the sick were cared for with-
in their own quarters. Those men who did
require prolonged hospitalization were sent
to the nearby general hospitals at Basking
Ridge (also spelled Baskinridge or Basken-
ridge) or Pluckemin, but in the period 1
March to 1 April 1780, 670 men, or 60
percent of the total requiring hospitalization,
did not leave the care of the regimental and
flying hospital surgeons. Only eighty-six died
from 17 December 1779 to 3 June 1780.
These patients were housed in regular huts
rather than in especially designed structures,
and the huts assigned during the winter to
the Pennsylvania Line were taken over in
June 1780 to serve as a general hospital for
the patients who had to be left behind when
the army left its winter encampment. Dr.
James Tilton has been traditionally credited
with having designed the Morristown hos-
pital huts, but recent research has shown
that Tilton’s design was apparently used
only once during this winter, not at Morris-
town but for an experimental general hos-
pital building at Basking Ridge, near Morris-
town.1?

The troops remaining along the Hudson
during the 1779-80 winter apparently fared
no better than those at Morristown. Severe
snowstorms began late in November and
alternated with freezing rain throughout
December. The effects of the weather upon
the men led Maj. Gen. William Heath to
comment that among the men spending the
winter there, the number who froze to death
rivaled the number returning to the army
after treatment at the New Windsor hos-
pital.13

As far as the Hospital Department was
104 THE ARMY MEDICAL DEPARTMENT, 1775-18138

 

From drawings by Dr. Tilton

TiLTons HospiTAL

MORRISTOWN
/780.

 

 

 

jx {ee

Fireplace

 

2

 

 

HospiTAL HUT DESIGNED BY DR. JAMES TILTON. (From Duncan, Medical Men.)

 
rm

I

Defeat to Victory: June 1778-1783

 

105

7" wr! = Z Fi -
Fr ere
lS
a

ROBINSON'S HOUSE. From the number of patients reportedly cared for here, it might be
assumed that other buildings in the same area were also used to house patients. (From

Duncan, Medical Men.)

concerned, conditions did not improve mar-
kedly with the coming of summer. In Au-
gust, Dr. James Craik commented that
“There is a large army without stores, sur-
geons or any thing comfortable for the
sick & wounded.” '* The number of sick
grew as the summer progressed, but there
continued to be little for patients to eat.
By early August, the hospital at Robinson’s
House, across the Hudson from West Point,
held 126 sick and hungry men. Discipline
and organization, furthermore, were so poor
that, although Cochran urgently needed
surgeons, doctors who could have helped
him were in Philadelphia and, the Medical
Committee was informed, had “no visible
employment.” 15

The main part of General Washington's
ragged army remained in New York for the
winter of 1780-81. Conditions were so poor
that mutinies began to break out once again
in early January 1781. It was at this difficult
time that Director General William Ship-
pen resigned.'¢

Figures in the Hospital Department re-
ports which have survived from this period
do not agree with the corresponding Army
monthly returns. Although at the end of
March 1781, for example, the return of the
new Director General, John Cochran, listed
a total of 288 patients remaining in regi-
mental and flying hospitals, the official
monthly return submitted by General Wash-
ington listed only 251 “sick present.” The
106

following May, however, when Cochran re-
ported a total of 398 men and 40 women
and children being cared for by all of the
Army's hospitals, the official return recorded
a total of 723 under the care of surgeons,
406 “sick present,” and 208 “sick absent”
among the rank and file and 109 in both
categories among the commissioned and non-
commissioned officers. The official month-
ly report for June listed 566 sick in all
categories, but the figure given by Cochran
for June is 408, with 218 of these in the
flying hospital. The discrepancies in the re-
ports of any one given month may, of
course, reflect differing base dates for the
reports, inaccurate reporting at one or more
levels, the inadvertent omission of one or
more units from one of the overall monthly
returns, or shifts in unit assignments between
the times of composition of the different
returns. Of the 288 listed by Cochran as
remaining in the regimental and flying hos-
pitals of the Army for March 1781, 43 were
termed “lame,” 18 “rheumatic,” and 14
“venereal.” In May, 41 of the 142 in the
flying hospital were suffering from “casual
hurts,” 19 were convalescent, 16 suffering
from intermittent and remittent fevers, and
6 from smallpox.!?

In June 1781, while preparing for opera-
tions against New York City, General Wash-
ington ordered his regimental surgeons to
send to the hospital at Robinson’s House all
patients unable to move with the army, ex-
cept for those with smallpox, who were to
be isolated in the huts used during the pre-
vious winter by New Hampshire troops.!® It
might be noted that this order for all prac-
tical purposes converted Robinson’s House
into a general hospital.

In July 1781, when the rate of sickness
appears to have dropped below 11 percent,
two flying hospitals were listed in Director
General Cochran’s records, without any
description or commentary to distinguish
between the two, one having forty-one pa-
tients remaining at the end of the month
and the other twenty-one. In the August

THE ARMY MEDICAL DEPARTMENT,

1775-18138

report, Cochran listed a flying hospital with
102 remaining at the end of that month
and another 207 patients remaining with
the “Army east” of the Hudson. Since Gen-
eral Washington, discouraged about opera-
tions against New York City, received word
in August that he could have the support
of the French force under Rear Admiral
de Grasse for an attack on the British in
eastern Virginia, by October there was a
flying hospital at Yorktown. Reports from
the army east of the Hudson continued to
come in, however, since forty-four remained
hospitalized there after forty-nine were sent
on to a general hospital.!®

Although the men camped along the Hud-
son saw no major action after the summer
of 1778, Indian and Loyalist attacks on
American settlements at Wyoming, Penn-
sylvania, on the Susquehanna River and at
Cherry Valley, New York, on the Mohawk
River in 1778, led in 1779 to a coordinated
campaign under the overall command of
Maj. Gen. John Sullivan against the per-
petrators of these massacres. (Map 7) Gen-
eral Sullivan personally led 2,500 men based
at Easton, Pennsylvania. Brig. Gen. James
Clinton commanded 1,500 men from New
York State and Col. Daniel Brodhead 600
men based at Fort Pitt, Pennsylvania. Gen-
eral Clinton’s units left Albany in the spring
of 1779 to establish a base at Canajoharie,
New York, and then moved southwest to the
Susquehanna River. They followed the river
to Tioga, where they met General Sullivan’s
men. Colonel Brodhead, however, because
of his inability to obtain adequate guides,
failed to meet the Sullivan-Clinton force at
Genesee, New York, as had been planned.

Before undertaking these operations, Gen-
eral Sullivan established a hospital unit at
Easton and ordered his regimental surgeons
to provide the necessary medicines for those
whose health would not permit them to ac-
company the expedition. Many of these pa-
tients were ill with intermittent fevers which
were blamed on the overly long baths they
were accustomed to taking in the river.
Ch. 5]

Defeat to Victory:

June 1778-1783 107

 

    
  

IROQUOIS NATION

Newtown

 

 

 

Tioga™\

BRODHEAD ono”
FORCE us?
S$

$

SO Sunbury

3

Tv WESTERN

At Fort Pitt PENNSYLVANIA

 

 

 

 

 

SULLIVAN EXPEDITION
1779

————— Route of advance

<€“~— ———— Route of return
0 50
fe

MILES

 

 

Cherry Valley,
0

  

J
Ze, Ss J
x El =<
Fort =

NEW YORK
( /
PENNSYLVANIA
q
Wyoming J & ~ N
o —70 &
S ?
%
“a, NEW
Qs, JERSEY
&
Castor

 

MAP 7

General Sullivan was among those whose
health was precarious at this time, but al-
though his condition seems to have gradually
worsened, he continued with his men
throughout the entire campaign.2®

Leaving Easton, General Sullivan’s men
moved on to Sunbury, where Dr. Francis

Alison was in the process of creating a
general hospital to care for their casualties,
arriving there on 21 June. Two days later
they continued on up the Susquehanna River
toward Wyoming. At Wyoming, General
Sullivan ordered his regimental surgeons to
report about their patients to the “Senr.

 
108 THE
Surgeon to the Flying Hospital” once a
week.?! An officer noted while here that
“A No. of the troops” were down with
“the dissentary.” ** In mid-July, the sick at
Wyoming were moved “to the genl Hospital
under the Direction of Doct. McCrea,” but
whether McCrea’s unit was the hospital
which seems to have remained at Wyoming
after General Sullivan’s troops left is not
clear.

Both before leaving Wyoming to contin-
ue his northward march and after arriving
at Tioga on 31 July, General Sullivan con-
tinued to plan the details of his order of
march. He decided that the Surgeon Gen-
eral, by whom he presumably meant the
head of the flying hospital, should remain
by his side, the surgeons attached to the
flying hospital, with their mates, should
march at the rear of the entire army, and
the regimental surgeons should remain at
the rear of their respective brigades or regi-
ments.

While awaiting General Clinton’s arrival
at Tioga, General Sullivan’s men built a
small fort which was duly named Fort Sul-
livan. Here also plans were made for the
operations of the next few weeks and regi-
mental surgeons were ordered to obtain the
supplies they believed they would need from
McCrea. The problem of supplying milk
for those staying at Tioga was among the
difficulties most easily met; by a decisic
worthy of Solomon, a cow whose owner-
ship was being disputed by two officers was
confiscated for the benefit of the hospital.”

On 26 August, after General Clinton’s ar-
rival at Tioga, General Sullivan, although he
was by this time too ill to ride his horse,
led the force north once again, leaving 250
able-bodied men behind to guard the hos-
pital. Three days later, they defeated a
combined Indian-Loyalist force near the
village of Newtown and suffered about forty
casualties. These men, along with those
few who had fallen ill since leaving Tioga,
were sent back to Fort Sullivan by water,

ARMY MEDICAL DEPARTMENT,

1775-1818

along with the heavy artillery and ammuni-
tion wagons, all of which threatened the
maneuverability of the force. As the expe-
dition continued forward, this procedure
was repeated, patients being sent back to
Tioga each time, usually by water, with a
small guard to ensure their safety on the
trip.2¢

After reaching Genesee on 14 September
and failing to encounter Colonel Brodhead’s
men, the expedition turned back toward
Tioga, arriving there 30 September. On 3
October, the sick and wounded were sent
on to Wyoming by water. When the main
army passed through that town, a small
group of officers was left behind to conduct
them to Easton.?7

An officer from the Sullivan expedition
estimated that the total casualty list, includ-
ing both the wounded and those dead be-
cause of enemy action or disease, did not
exceed fifty. The total number of those who
became ill at some time during the expe-
dition, however, is difficult to estimate, al-
though one authority suggests a figure
approaching 450.28

Patients not only from General Sullivan’s
army but also from that of General Wash-
ington necessitated the opening or expanding
of a number of general hospitals even when
some of those in operation in the winter
of 1777-78 were being closed down. In the
fall of 1778, Shippen was confident that the
few hospitals remaining in both the Middle
Department and the Eastern Department
were functioning well. Only six months later,
however, a Hospital Department physician
stated that while he agreed that the Middle
Department was “really now upon a respect-
able footing,” in the Northern and Eastern
Departments, “everything is carried on, as
in the beginning, with wild anarchy and
uproar.” 29

In the Middle Department, by the fall of
1778, a number of the older units in Penn-
sylvania and New Jersey were apparently
closed or on the verge of closing, but in the
Ch. 5]

following three years, others within the de-
partment opened in response to the needs of
the Army’s operations.

The Schaefferstown, Pennsylvania, hos-
pital was caring for seventy patients in early
August of 1778 but does not appear in later
records. A unit at French Creek, Pennsyl-
vania, held 130 patients in September and
89 a month later. It is possible that this
unit was later included in reports as a
part of the Yellow Springs hospital, but it
does not appear under its own name after
October. There was also a unit at Downing-
town, Pennsylvania, west of Philadelphia, in
the summer of 1778, where in early August
there were approximately seventy patients,
but further information on this facility, too,
is lacking. The Lititz, Pennsylvania, hos-
pital was closed in late August 1778 and
its patients were moved to Yellow Springs.
The unit at Reading, Pennsylvania, was
closed as of 1 January 1779, although hos-
pital stores were apparently still being kept
there the following spring.®°

The facility at Yellow Springs was
destined through the two years following
1778 to take in all the patients still remain-
ing in other Pennsylvania hospitals outside
of Philadelphia. In October 1778, there
were 115 recorded at Yellow Springs; after
this point, the number there began to de-
cline. The unit continued to be highly re-
garded, however, and the Reverend Dr.
James Sproat recorded his belief that “the
hospitals |are| well provided for, and the
gentlemen take good care of the sick,”
despite the fact that Dr. Bodo Otto, director
of the unit, continued to find it necessary to
plead for stores and clothing for his patients
and salaries for his staff.3!

By mid-1780 only fifty-one patients were
still at the Yellow Springs hospital, all of
whom were suffering from “chronic affec-
tions.” In September 1781, when fewer than
thirty patients could be found there, even
before the victory at Yorktown, the Conti-
nental Congress finally ordered the Yellow

Defeat to Victory: June 1778-1783

109

Springs hospital closed and the remaining
patients moved to Philadelphia.®?

In July 1778, not long after the British
evacuated Philadelphia, the Hospital De-
partment reopened its facility in the Better-
ing House there. Dr. Jonathan Potts and
Dr. Thomas Bond, Jr., then arranged with
the managers of the privately owned Phila-
delphia Hospital to use that institution’s
“elaboratory” as a Hospital Department
pharmacy. In September, Bond, whose
father was one of the founders of the
Philadelphia Hospital, also arranged to have
some of the Army’s convalescents taken in
there, agreeing to give the hospital control
over what cases could be admitted. The
Army was to be held responsible for bedding
and provisions as well as for the pay of
nurses. 3?

The charity hospital in Philadelphia ap-
pears to have served as an emergency over-
flow facility for the department’s Bettering
House several times during the last years
of the Revolution. In the spring of 1779,
for example, the Bettering House was again
overcrowded, and in late March a depart-
ment spokesman asked the Philadelphia
Hospital to take in more convalescents. On
this occasion the hospital board refused to
do so and referred scathingly to the “In-
expediency and impropriety of the request.”
The board maintained that it had been as-
sured that the use of the laboratory was all
that would be asked of it.** The behavior of
soldier-patients appears to have been the
principal cause of the board’s wrath, since
when Bond agreed to have a physician re-
main with Continental patients and to per-
sonally “do everything in his power to
restrain the Soldiery, and prevent their
committing damages and behaving irregu-
larly,” he was able to obtain a reversal of
the adverse decision. Bond also agreed to
try to have these convalescent soldiers out
of the Philadelphia Hospital within six
weeks and to guarantee that no patient with
an infectious disease would be brought in.
110

On this occasion the department used only
a garret and a lower ward and again pro-
vided bedding and food as well as firewood
and other necessities. On 16 June 1779,
having removed the Army’s patients from
the charity hospital, Bond was careful to
thank the board for the use of the hospital’s
rooms. During the next year, the number
of patients in the Hospital Department’s fa-
cilities fluctuated, from a high of 130 in
December 1779 to a low of 4 in May 1780.
Once again in the summer of 1781, Hos-
pital Department facilities in Philadelphia
were so crowded that the department turned
to the Philadelphia Hospital for help with
its patients, who included about ninety sick
British prisoners. This time it was the
Superintendent of Finance Robert Morris
who worked out an agreement with the hos-
pital board which permitted the department
to send soldiers to that institution. The
department was to pay 15 shillings a week
for each man and to agree that military
patients would be required to obey the
hospital’s rules.33

In 1780, the Continental Congress urged
its Medical Committee to move the depart-
ment hospital out of Philadelphia to a site
where the cost of living would be lower.
Nevertheless, although by 1780 there were
more hospitals in New Jersey than in Penn-
sylvania, Philadelphia remained the site both
of a department hospital and of a hospital
stores warehouse. The number of patients
there may well have remained small, how-
ever, until the fall of 1781, when from the
eight reported in July, the number rose in
September to seventy-two and in October to
eighty-five.3¢ There was also a general
hospital at Baltimore, Maryland, which
stayed open through the summer of 1778.
In August of that year, this facility began
to dismiss its last patients, furloughing some
and distributing the rest among relatives, so
that by September it was no longer in
operation.37

The old New Jersey hospitals at Trenton

THE ARMY MEDICAL DEPARTMENT,

1775-1818

and Princeton appear only sporadically in
reports dating from mid-1778 to the end of
1781. (See Map 6.) Twenty patients were
at Trenton on December 1779, ten at the
end of March 1781, and nine a month later.
The Princeton hospital may have been open
in the summer of 1778, at which time a
typhus epidemic was reported raging there,
but it does not appear in the reports of any
later period. Also mentioned in the records
surviving from 1778-79 was the unit at
Brunswick which cared for some of the
men who fell ill after the battle of Mon-
mouth and served the Middlebrook camp
the following winter.38

Among the new hospitals set up in the
Middle Department in the last years of the
war were three facilities in Pennsylvania,
which cared almost exclusively for patients
from General Sullivan’s campaign against
the Indians and Loyalists, and two in New
Jersey which managed the care of General
Washington’s sick and wounded.

According to the 6 October 1779 re-
port of Director General Shippen, the three
fixed hospitals serving patients from the
various units operating against the Indians
and Tories in 1779 were at Fort Pitt, Penn-
sylvania, which presumably cared for
Colonel Brodhead’s casualties, at Sunbury,
Pennsylvania, and at Fort Sullivan at Tioga,
Pennsylvania. (See Map 7.) The records of
the Fort Pitt and Tioga facilities are few,
while those of the Sunbury hospital, more
numerous, are not always entirely legible.

Shippen listed thirty patients at Fort Pitt
and thirty-seven at Fort Sullivan on 6
October 1779. On 31 December he recorded
thirty still at Fort Pitt but made no refer-

ence to any patients remaining at the Tioga

facility, which was evacuated early in the
fall at the conclusion of the campaign. The
returns from the Sunbury unit began in the
summer of 1779. They indicate that during
the following months only a minority of
Sunbury’s patients were suffering from
wounds. Of the 165 patients remaining there
Ch. 5]

on 22 September 1779, for example, the
diagnosis in 31 instances was bilious fever,
in 11 diarrhea, and in 19 dysentery, but
only 33 were listed as wounded. In the fall,
with the campaign over, the number of
patients at Sunbury began to drop, reaching
28 by mid-December 1779, and the pro-
portion classified as convalescent to rise
until it reached over 50 percent early in
1780.39

The conditions most frequently bringing
sick men to Sunbury included a high pro-
portion of dysentery and diarrhealike ail-
ments, although by the autumn of 1779 this
type of illness appeared less frequently.
Other diseases seen in significant quantity
were “lues veneria,” bilious and intermittent
fevers, rheumatism, and ophthalmia.*°

By mid-April 1780, when the last report
to be found among the papers of the physi-
cian who directed the Sunbury unit was
prepared, only twelve patients remained
there, four being convalescent, five wounded,
and one each suffering from dysentery,
asthma, and rheumatism. Precisely when
this hospital finally closed its doors is not
known, but since plans were being laid for
its termination as early as October 1779,%
we can perhaps assume it did not remain
open much after the spring of 1780, when
its patient load had become quite small.

The three new general hospitals opened
in New Jersey first appeared in records
dating from 1779. (See Map 6.) Two,
those at Basking Ridge and at Pluckemin,
were destined to care for patients during
the grim winter spent by General Washing-
ton’s men at Morristown. The latter unit
was opened in the summer of 1779 when
the general ordered that patients who were
being cared for in barns in the vicinity of
the Middlebrook camp be moved to the huts
which had been used during the preceding
winter by the artillerymen of Brig. Gen.
Henry Knox at Pluckemin. By October
1779, ninety-eight patients were on the
rolls of the new hospital.42

Defeat to Victory:

June 1778-1783 111

The second New Jersey hospital serving
Morristown opened in the winter of 1779-
80 at Basking Ridge, under Tilton’s direc-
tion. Here a log building on a hill near a
brook appears to have been Tilton's famed
experimental hospital hut. It was apparently
Basking Ridge’s main building, since the
facility could hold more than half of the
maximum number of fifty-five patients re-
ported being cared for at Basking Ridge at
one time. Among the features of this struc-
ture were smaller units than those usually
found, packed earth floors, walls without
windows, and a fireplace in each section, the
smoke from which left the room by means of
a four-inch hole in the roof. As many as
twenty-eight patients were placed here, with
their feet toward the fire.

While the number of patients at the
Pluckemin facility increased throughout
carly 1780, that at Basking Ridge declined.
The two hospitals, however, shared a com-
mon problem at this time in the form of
patients who, upon recovery, chose to desert
rather than return to duty.** By summer,
the patient load at both hospitals had begun
to fall oft until on 1 July 1780 they held
only fifty-three patients between them.

Beginning in the summer of 1780, the
huts serving the Pennsylvania Line during
the second Morristown encampment were
taken over for a third New Jersey general
hospital, established to care for the sick who
were left in camp when the army returned
to New York State. The huts at Morristown
were small and in very bad condition,
partially because of the “disorderly Be-
havior of the Patients.” Only in a few in-
stances were the individual compartments
large enough to hold three men. Most of the
huts did not provide adequate shelter from
the rain and snow. Nevertheless, in the fall
of 1780, patients from units in the area of
Paramus, New Jersey, which was considered
to be threatened by possible enemy action,
were ordered moved to Morristown. In
January 1781, Dr. Malachi Treat, reporting
112

on the situation at the Pennsylvania huts,
urged that the patients at Morristown be
transferred to Trenton. He pointed out that,
in addition to its thirty-five patients, the
unit was encumbered by many women and
children “who are a Nuisance at present.”
By March 1781, there were only nineteen
patients in the huts, six of whom were classi-
fied as convalescent and five as wounded,
and no new patients were being admitted.
The number of patients continued to go
down, and in June the hospital was closed.*®

In theory, the setting of the Hudson River
as the boundary between the Middle and
Eastern Departments should have prevented
any confusion over the extent of the au-
thority of the head of the Eastern Depart-
ment. The documents of the period, how-
ever, show Foster, the Deputy Director for
the Eastern Department, exercising authori-
ty over storage facilities on the west bank
of the Hudson. The hospital at Fishkill, to
the east of the river, on the other hand,
seems to have been in some ways inde-
pendent of the Eastern Department. How
much this confusion of authority added to
the dissension which characterized this de-
partment in the years 1778-80 cannot be
ascertained, but the personal antagonisms
prevailing among Eastern Department phy-
sicians at this time were a matter of record.*®

Named without indication of state on an
Eastern Department return of the fall of
1778 were hospitals at Boston, Bedford,
Poundridge, Springfield, Fishkill, and Dan-
bury. It was a 1780 return, however, that
listed Fishkill but maintained that no report
had been received from the Eastern Depart-
ment. Furthermore, a Middle Department
physician, Dr. Charles McKnight, was in
charge at Fishkill. This hospital had at least
one small claim to fame; it was here that
Cochran attended the Marquis de Lafayette
while that nobleman was seriously ill with a
fever.t7

The Fishkill unit was still in operation in
mid-1781 and its patients numbered as

THE ARMY MEDICAL DEPARTMENT,

1775-1818

many as forty-five. The diseases found here
included rheumatism and venereal diseases
while the number of wounded in 1781 was
low, apparently less than half a dozen. By
July 1781, however, the decision to close
the Fishkill hospital had been made.*®

Two more Hudson River hospitals were
those at New Windsor and at Robinson’s
House, but considerable confusion exists
concerning both their status and the details
of their operation. The New Windsor fa-
cility, located at this time in a church large
enough to accommodate fifty patients, may
have served as an administration center for
some of the other units along the river, since
Dr. Francis Alison, sent to the area in the
fall of 1778, worked at Robinson’s House,
on the east bank of the Hudson, but sent his
returns in to New Windsor.* The Robin-
son’s House hospital was still referred to as a
flying hospital, despite the fact that on a re-
turn of May 1781, it was listed separately
from the flying hospital.?® The overall capac-
ity of the Robinson’s House unit seems to
have been comparable to that of the hospital
at New Windsor, and in the summer of
1780, when it held 126, it was considered to
be seriously overcrowded. This condition
was relieved by sending some of these men
to Fishkill.

At some point in the winter of 1780-81,
both the Robinson’s House and the New
Windsor units appear to have been closed,
for in July 1871, before General Washing-
ton’s army moved south to besiege York-
town, Director General Cochran referred to
new hospitals which he had only recently
established at Robinson’s House and huts
formerly used by artillery units at New
Windsor as well as in the barracks of West
Point.>2

Reports were again submitted for the unit
at Robinson’s House beginning in May 1781
and running at least through October of that
year. The number of patients in that period
varied from 60 to 142. A high proportion
of these in the fall were suffering from bilious
Ch. 5]

putrid fever, 57 percent, for example, in
October. Reports from the New Windsor
huts apparently began to come in by July
1781. The number of patients ranged from
96 in July to an estimated 250 in October.
Here, too, the number of cases of bilious
putrid fever rose sharply with the onset of
autumn, as did those described as intermit-
tent and remittent fevers. The West Point
unit was in a barracks and served the garri-
son there. Of the 135 men hospitalized at
West Point in the month of September 1781,
more than half were ill with dysentery.’
Two other hospitals, both quite large and
located not far from the Hudson River, ap-
pear on a single Hospital Department re-
turn, that of 6 October 1779, but are never
mentioned again in the records which have
survived from that period. The Otterkill
facility, located quite close to New Windsor
on the west bank of the river, held 112
patients at this time. (See Map 6.) It was
not identical with the New Windsor facility,
which was listed separately on the same re-
port. There is no indication given as to why
the existence of such a large facility as that
at Otterkill should have been so brief. The
second of these two units, at New Hacken-
sack, on the east side of the Hudson, was
comparable in size to that at Otterkill, and
its origins and fate are equally mysterious.?*
A large number of hospitals of varying
size also operated in New England in the
period 1778-81. Among the largest of these
was the unit at Danbury, Connecticut, which
admitted 938 patients in the course of
September and October 1778. (See Map 6.)
Of these, 69 died and 716 were dismissed
as cured. Of the 294 remaining at the end
of October, 208 were classified as conva-
lescents. Some of the men at Danbury were
probably those transferred there from smal-
ler units to the west whose security was
considered to be threatened by their proxi-
mity to the British in New York City.%
Although no returns exist from Danbury
after that of 7 November 1778, when 162

Defeat to Victory:

June 1778-1783 113
of its 197 patients were convalescent, the
hospital there continued in operation at
least through the spring of 1780 and was
quite possibly still functioning a year later.
Like the patients at other hospitals in this
period, those at Danbury suffered from the
shortages afflicting the Hospital Department,
particularly a lack of straw for bedding and
vegetables.®®

At least two other Eastern Department
units reporting on their patients in the
early autumn of 1778 seem to have been
closed by the end of October. One of these
was at Bedford, New York. (See Map 6.)
During September and October, Bedford
admitted 107 patients, 59 of whom were
considered cured before the unit was closed.
In August 1780, however, the Bedford hos-
pital was open again and caring for 300
to 400 patients, according to Dr. William
Eustis.??

Poundridge, New York, twenty miles
northeast of White Plains, admitted seventy-
four patients in the early fall of 1778, one
of whom died and only one of whom was
claimed to have been cured. It is possible
that this hospital was also considered en-
dangered by its proximity to New York
City and its patients were moved elsewhere,
perhaps to Danbury.%8

There were at least two other general
hospitals in Connecticut and one in Rhode
Island during this period. (See Map 6.)
The facility at Hartford, established for
the sick and wounded of units stationed
near that town, was short-lived. This hos-
pital was closed in March 1779 and its pa-
tients were sent to New London. The latter
unit may also have been closed not long
after this time, for in the spring of 1780, the
Continental Congress ordered Shippen to
open a facility in New London to receive
such sick prisoners as might be exchanged
by the British and in so doing made no
reference to any institution already existing
there. This unit appears to have been little
used and was closed in the spring of 1781.
114

Dr. James Thacher in his Military Journal
also mentioned a hospital at Providence,
Rhode Island, operating in 1779, and Dr.
Philip Turner’s 1778 return listed patients
at a unit at Springfield, in an unmentioned
state.%?

There was a general hospital at Boston,
Massachusetts, during this entire period,
under the direction of Dr. John Warren,
who, like Shippen, conducted classes while
he served as a member of the Hospital De-
partment. The hospital, like so many others,
experienced severe supply shortages. Many
returns in the period complain that no report
had been received from the Eastern Depart-
ment, or, specifically, none from Boston,
and indications of the capacity of the
Boston facility were, for this reason, scarce.
A total of thirty-six patients were being
cared for there at the end of October 1778
and thirty-seven in the spring of 1781.6

In the spring of 1778, the days of the
Albany general hospital, the one remaining
general hospital in the Northern Depart-
ment, where Robert Johnston was acting
as Deputy Director, had seemed numbered.
(See Chapter 4.) Before the launching of
the Sullivan expedition, many of the pa-
tients there were chronically ill or perma-
nently crippled. Many of the other patients
were ready to rejoin their units but unable to
do so because of a lack of clothing. Gen-
eral Washington attempted to remedy this
situation early in 1779 by ordering clothing
sent north and requesting General Clinton
to be most careful in its distribution. At
the end of January 1779, Treat, Physician
General in the Northern Department, main-
tained that all was going relatively well at
the “out Post of God's Creations” where
“your Eyes behold only Dutchmen” in spite
of the continued lack of money and the
fact that the clothing ordered for patients
ready to return to their units had not yet
arrived.5!

When General Clinton set out to join
General Sullivan in the campaign against

THE ARMY MEDICAL DEPARTMENT,

1775-1818

the Indians and Loyalists, he decided to
leave behind him in charge of the guard for
the Albany hospital one Captain Gregg,
the same officer who had earlier survived a
scalping. Captain Gregg’s wish to join the
operations against the Indians was not
granted by General Clinton, who com-
mented that “if the Indians ketches him
again they will Cut of [sic] his head as
scalping Can't kill him.” 62

On 6 October 1779, only fifteen patients
remained at Albany, but from that date to
31 December of that year, the patient load
increased to 140. During this same period,
the number of patients at Sunbury dropped
markedly twice in close succession. The
number at Albany slowly decreased after
the end of 1779, reaching 86 by the end
of February 1780, 62 at the end of March,
and 35 by early July. By August 1780, it
was being suggested that although there were
six surgeons at Albany, one would suffice
and the others should be sent to where they
were more needed.%?

All was not well at the Albany hospital
in the summer of 1780, however, despite
the plethora of physicians. Treat wrote
the Medical Committee of the Continental
Congress that “Our hospital is at present
destitute of everything that can afford Com-
fort to a sick soldier” and that the hospital
had no wine, sugar, tea, coffee, rice, or
molasses and only a little rum, a state of
affairs which was neither new nor unique.%*

The patients at Albany still numbered
more than thirty in the spring of 1781, and
a report of May 1781 added that twenty-
seven women and children were also being
cared for by the hospital. Throughout the
summer and early fall the number of pa-
tients at Albany fluctuated between sixty
and ninety and the recorded diagnoses were
scattered among many diseases, including
intermittent and remittent fevers, dysentery
and diarrhea, rheumatism, and ‘various
chronic.” % The shortage of supplies con-
tinued “and the sick suffer extremely at
Ch. 5]

times for want of provisions,” but by the
summer of 1781 the staff at Albany had
been reduced to one surgeon and four
mates.

Smallpox was no longer among the
diseases most frequently listed by the Army’s
surgeons in any of the departments. The
lesson taught by the devasting effects of
smallpox in the early years of the Revolu-
tion was not forgotten in the later years
and care was usually taken, north of the
Carolinas, once the campaign season was
out of the way each year, to inoculate
those who were not already immune to the
disease, especially if smallpox had already
begun to appear among the men. The
women and children accompanying the
army might also be inoculated and although
some of the men were not in good condi-
tion when subjected to this procedure, the
death rate was still quite low, in one in-
stance only four of 500.%7

An added responsibility for the Hospital
Department developed in July 1780, when
4,000 troops of the French Army under
the Comte de Rochambeau arrived off New
England to aid in the fighting against Great
Britain. In anticipation of their arrival,
General Washington and the Marquis de
Lafayette began in the spring of 1780 to
plan to acquire appropriate accommoda-
tions for patients from the French forces.
The American general ordered Craik, as his
personal friend and then Assistant Director
General in the Middle Department, to take
over responsibility for the establishment of
a hospital near Providence, Rhode Island,
for the new allies and urged specifically
that Craik acquire sufficient space. These
facilities were to contain room for a kitchen,
an apothecary shop, storage, a bakery, and
surgeons’ quarters. There should also be
enough meat and vegetables on hand to
meet the initial needs of the French
troops. 8

Craik experienced considerable opposi-
tion from Rhode Island citizens, however,

Defeat to Victory:

June 1778-1783 115
when he first tried to find the desired fa-
cilities. Local inhabitants apparently re-
garded hospitals as foci of infection and
were of the opinion that the plague would
arrive with the French fleet. At last Rhode
Island College (now Brown University) in
Providence surrendered its buildings for this
purpose. In time, the French created their
own hospital establishments at other sites,
including Conanicut Island in Narragansett
Bay. It was fortunate, indeed, however,
that the initial housing problems were
solved by 11 July, when the French fleet
arrived off Newport, Rhode Island, because
an estimated 1,700 to 2,600 Frenchmen
of both the army and the navy were suffering
from scurvy. The French, furthermore, had
not been long in Rhode Island before their
men began to show symptoms of dysentery
as well. Fortunately, the French Army’s
medical organization was highly developed
and the physicians were thoroughly capable
of caring for their own men.%®

SOUTH OF THE PoToMAC:
BEFORE THE VICTORY
AT YORKTOWN

As far as the care of sick and wounded
soldiers was concerned, the South was, until
March 1781, for all practical purposes
divided into three sections, only one of
which was a part of the Continental Hos-
pital Department system. (Map 8) Although
its position in relation to the position of
Director General was at times in dispute,
the establishment in Virginia was, from its
inception, a part of the Hospital Depart-
ment. (See Table 1.) In the Carolinas and
Georgia, however, two separate systems, one
centered about Charleston, South Carolina,
and the other covering North Carolina,
gradually emerged, independent both of the
Hospital Department and of each other. The
existence and the independence of hospitals
south of Virginia were recognized, more or
less in passing, by the legislation of Sep-
116 THE ARMY MEDICAL DEPARTMENT, 1775-1818

  
  
      
   

 

Harrisburg

| Philadelphia
PENNSYLVANIA York 5N
T Camden

Q a
{Wilmington dq
S

      
      
   
  
 
   
 
     
    
     

e————— 7 NJ
beep rl ~TNAM 1 kead of Elk o
Sees Baltigtore

’
2.8
L q oN (
Q
Alexandria
Colchester ~

Charlottesville 5
Beaverdam

 

lanover =
QO
\ | R G | N | A Richmond “re, ,,
Chesterfield Court House QO ~,
Petersburg 5reer

Spring

_Guilford

Court

2 House
Cc

Hillsboro
Oo

    
  
  
    
 
 

A

  

5
<1 N) ©
UA Charlotte’ |
— — —— i — Cl, | — King's \
be We ne fn,

  

(SPAIN)

 

 

MAP 8
Ch. 5]

tember 1780, and the Director General of
the Hospital Department did not formally
assume responsibility for the operations of
these institutions until 22 March 1781, at
which time units from the North were mov-
ing into the South in ever greater numbers.
Even under these circumstances, however,
the congressmen from South Carolina op-
posed the subordination of the system in
their state to the Hospital Department.”

The first general hospital established for
American troops fighting south of Virginia
was apparently that created in June 1776
in the Charleston area under Charleston’s
Dr. David Oliphant for “State troops, Mili-
tia, Sailors and Negroes in the public Serv-
ice.” Although some seem to have thought
that Oliphant should have been responsible
to the Hospital Department, he did not
consider himself to be so and the post in
which he served was not a creation of the
Continental Congress.”

In time, as the tempo of the war in the
South began to increase, Oliphant was en-
couraged to set up a medical organization
which would include all of South Carolina
and Georgia as well, a course of action
which must have seemed particularly de-
sirable because of the heavy toll which sick-
ness was taking from the forces fighting
the British in the South. At somewhat the
same time, the sick and wounded in North
Carolina (or perhaps only those of the
militia of that state) were placed under the
overall direction of Dr. Hugh Williamson.
The operations of Oliphant’s organization
were severely impeded when its members
were captured by the British on 12 May
1780, at the time of Maj. Gen. Benjamin
Lincoln’s surrender of Charleston. It was
these men, nevertheless, who attempted,
with little cooperation from their captors,
to care for the sick and wounded among
the American prisoners accumulated by
the British at Charleston. Despite British
denials, it appears that the general lack of
cooperation these physicians received from

Defeat to Victory: June 1778-1783

117

 

DAvID OLIPHANT. (Courtesy of National Li-
brary of Medicine.)

the enemy was matched by the experiences
of Williamson when he crossed enemy lines
to care for prisoners wounded at Camden,
South Carolina, later that year.”

From the spring of 1780 onward, the
medical care received by the troops south
of the Virginia-North Carolina border seems
to have been haphazard, lacking both organ-
ization and physicians, as well as nurses,
food, and medicines. Despite the efforts of
Maj. Gen. Horatio Gates to establish a
general hospital and an appeal to Dr. Wil-
liam Rickman as “Director of the General
Hospital of the Southern Army,” for aid,
care was almost, if not entirely, in the hands
of regimental and militia surgeons. It ap-
pears, indeed, that, except for regimental
surgeons, such representatives of the Hos-
pital Department as were with units moved
in from the North may have been required
to stay behind when the troops crossed into
118

 

THoMAs TuDoR TUCKER. (Courtesy of Nation-
al Library of Medicine.)

North Carolina. One authority reports,
furthermore, that there seemed to be not
a single American surgeon of any kind in
attendance for the battle of King’s Mountain
in October 1780.7

The September 1780 reorganization of
the Hospital Department officially recog-
nized the existence of the hospitals south of
Virginia, although it neither defined the
relationship of these institutions to the Hos-
pital Department nor affected the work
of physicians south of Virginia. The growing
pace of activity in this area, however, re-
quired that an attempt be made to impose
some form of organization upon the physi-
cians caring for the men under Maj. Gen.
Nathanael Greene, who was appointed to
command in the South in October 1780.
A general hospital seems to have evolved
at Charlotte, North Carolina, during the
summer of 1780, but the care provided
there, which was largely, if not entirely, in
the hands of volunteer physicians, was very
poor and, in General Greene's opinion,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

“shocking to humanity.” In November, a
Board of War meeting at Hillsboro, North
Carolina, appointed Dr. James Browne
director of the medical establishment in
that state and assigned Williamson to the
post of surgeon general. One author believes
that Browne had been in charge of a hos-
pital caring for General Greene's men at
Cheraw, South Carolina.”

At about the same time, plans were also
being made to transfer the Charlotte facility
to Salisbury, North Carolina, where it was
to be directed by Dr. William Read. Read,
however, had barely established his hospital
when General Greene began his retreat north
into Virginia and the hospital had to be
evacuated. Patients unable to ride on this
occasion were, according to Read, moved
on litters.”

In South Carolina, Oliphant was paroled
by the British during the winter of 1781,
but he remained in charge of the hospital
for the American prisoners at Charleston.
His chief assistant, Dr. Peter Fayssoux, as
well as two junior hospital surgeons and
four regimental surgeons, was exchanged
in March 1781.7

In the spring of 1781, however, Dr.
David Oliphant became Deputy Director
for the area south of Virginia, with a deputy
purveyor, chief physician of the hospital,
chief physician of the army, and two hos-
pital physicians under him. Despite the
organizational change, inadequate care, as
before, continued to add to the sufferings of
men who were wounded or who became
ill while serving in the South. Oliphant
seems not to have been active on their
behalf at this time and one of the physicians
under him, Dr. Thomas Tudor Tucker,
served as director of the Charleston hos-
pital, which was still held captive by the
British. The regiments which came in from
North Carolina were in a particularly poor
situation because they had neither physicians
nor medicines of any kind.”

As the heat of summer began to settle
Ch. 5]

upon “a country as hot as the Antichambers
of Hell,” the incidence of disease mounted,
triggering an increase in the number of
desertions.”™ Fatigue and “frequent skir-
mishes” also added to the list of the dis-
abled. The situation was made worse by
the fact that a large quantity of the hospital
stores was destroyed by the raids of the
much dreaded British Lt. Col. Banastre
Tarleton.”

Fighting in the summer months this far
south was generally considered unwise, and
so, as the temperature reached its peak,
Maj. Gen. Nathanael Greene, now com-
manding in the Southern Army, led his men
to camp for the summer in the High Hills of
Santee in South Carolina. Dr. William Read,
in charge of a hospital at Charlotte, North
Carolina (a unit which had been reestab-
lished there after having been moved earlier
to Salisbury), was ordered to leave that
facility in charge of a subordinate and to
join General Greene to create and direct a
flying hospital for his army. It appears that
the chief physician of the hospital for
General Greene's army was at this time
Fayssoux, who joined him after being re-
leased from Charleston as the result of an
exchange of prisoners in March 1781.80

The health of General Greene’s men,
while it may have benefited to some degree
from the summer spent in the High Hills of
Santee, was far from what might have been
hoped for by the beginning of the autumn
campaign season. Many hundreds were still
sick, and supplies of bark, inadequate from
the outset, were totally exhausted by mid-
October. Oliphant was by now in Philadel-
phia, but the number of patients under
Fayssoux, acting in his stead, increased
after the engagement at Eutaw Springs,
South Carolina, on September 1781, when
more than 250 men were wounded, and
physicians were themselves now falling ill.
The burden of nursing fell on soldiers
fortunate enough not to be seriously ill or
wounded, few of whom had any real apti-

Defeat to Victory: June 1778-1783

 

WILLIAM READ. (Courtesy of National Library
of Medicine.)

tude for this type of work. General Greene
was profoundly distressed by the inadequate
care his wounded were receiving and noted
that “numbers of brave fellows who had
bled in the cause of their country, have
been eat up with maggots, and perished in
that miserable situation.” *!

The sick among those still imprisoned at
Charleston in the late spring and summer of
1781 were many. Oliphant claimed, how-
ever, that the British were forcing ill
prisoners to leave the hospital before they
had completely regained their health and
were feeding those still in the hospital a
“salt diet,” rather than supplying the type of
nourishment considered necessary for sick
men in a hot climate. Unfortunately, the
Continental Congress, because of the short-
age of funds, was unable to supplement
this diet. That body did, however, retain
in service the Continental physicians of the
South Carolina system, who, in captivity
themselves, were caring for the wretched
men at Charleston.5?

The hospital system in Virginia was
120

directed by Dr. William Rickman and was
independent of that in the colonies further
south. It is difficult to pinpoint exactly
where Rickman’s facilities were located in
the summer of 1778, although he had ap-
parently rejected the College of William
and Mary because it had too many parti-
tions which would interfere with the free
circulation of air. Private homes had been
deemed less than ideal because they implied
a larger staff and higher operating costs.
The palace at Williamsburg, used as a hos-
pital during the siege of Yorktown, was
seriously considered by Rickman several
years earlier but was not taken over at that
time. $3

It is possible that a facility called the
Vineyard Hospital, outside of Williamsburg
on the road to Yorktown, was used for both
Continental and Virginia militia patients
beginning at least as early as May 1779,
and that private homes, despite the dis-
advantages, were used before that time to
house Army patients. Since recruits were at
times inoculated in Virginia, special facilities
were also set aside when needed as smallpox
hospitals, such as those used in 1777 at
Dumfries, Colchester, and Alexandria.8*

A hospital was apparently in operation in
the fall of 1778 near Fredericksburg, Vir-
ginia, at the time that units under the com-
mand of Maj. Gen. Benjamin Lincoln,
newly appointed to command in the South,
were passing through, since on 25 October,
Cochran reported that 562 patients were
being cared for in this area. Of these, 65
were described as flying hospital patients,
166 convalescent, 111 sick with either
intermittent or remittent fever, 83 with
bilious fever, and 34 “lame & rheuma-
tism.” 8 It is difficult to say whether this
unit was serving as both flying and general
hospital or whether those referred to as
flying hospital patients were merely those
transferred from the flying hospital.

In 1779, when General Washington began
moving all Carolina and Virginia troops

THE ARMY MEDICAL DEPARTMENT,

1775-1818

south, at least one of these units, that
under the command of Brig. Gen. Charles
Scott, was not accompanied by an adequate
number of medical attendants. General
Washington at first suggested that Rickman
supply the deficiencies, but finally, since
Scott was in “utmost distress” on this ac-
count, he turned to Shippen with the request
that the Director General send two surgeons
and two mates to join General Scott at
Petersburg, Virginia. At least one surgeon
and one mate joined General Scott in the
summer of 1779, but twenty to thirty pa-
tients who could not move with his unit
were left behind at Petersburg without a
single surgeon to care for them. Despite the
unhealthy reputation of that town, Conti-
nental hospital facilities were still there in
the fall of 1780.86

Another Virginia hospital was established
by Rickman in the spring of 1780 at Ches-
terfield Court House, which seems to have
been along the route taken by troops moving
into the Carolinas. This particular site was
not the first choice of the Hospital Depart-
ment but was urged upon it by the governor
of Virginia. In early June, eighteen patients
were being treated here, but by the end
of the year, the log house which sheltered the
unit was not finished and medicines, as
elsewhere, were badly needed. The unit was
still in operation in March 1781, with 55
patients on its rolls, 17 of them wounded
and 25 convalescent.®7

By the spring of 1781, however, Rick-
man was no longer in charge of the hospital
in Virginia, having been dropped from the
department at his own request the preceding
fall. The identity of his successors is un-
clear. Dr. David Gould, who may have
been his first replacement, died in July
1781. Either Dr. Goodwin Wilson, who
supervised facilities at Beaverdam, Hanover,
and Charlottesville at some time in 1781,
or Dr. James McClurg may have followed
Gould.®8

In the spring of 1781, the British troops
Ch. 5]

under Lt. Gen. Charles Cornwallis marched
north into Virginia and joined the units
already in that area. Shortly after their ar-
rival, reinforcements from New York joined
them. The tempo of the war in that state,
therefore, increased, and by midsummer,
the hospital at Williamsburg was the main
southern facility for the Hospital Depart-
ment. This unit appears initially to have
been under the direction of Tucker, who
came up with his patients upon their
release from Charleston.8?

In the late spring of 1781, the men of
Maj. Gen. Anthony Wayne’s command be-
gan to move south. On 4 June, their sick
were left behind them just south of Lees-
burg, Virginia, under the care of a surgeon.
On 10 June, Wayne joined Lafayette on
the North Anna River, and by 19 June, both
units were in the vicinity of Richmond and
“destitute of every necessary, both of life
and convenience.” Many of the physicians
accompanying General Wayne did not have
so much as blood-letting instruments.%°

On 6 July, the combined forces of Gen-
eral Wayne and Lafayette met the British
at Green Spring, Virginia, where General
Wayne’s men, who took the brunt of the
action, suffered ninety-nine wounded. These
men were cared for at a church nearby and
on the 7th sent to an unidentified hospital.

The number of sick from both Conti-
nental and French units in Virginia in-
creased during the late summer, and wagons
moved flying hospital patients from place
to place in the heat. In early August, some
of the sick from among General Wayne's
men were sent to a general hospital located
in a private home at Hanover, Virginia;
the officers from this group were moved
on to Pennsylvania later in the month. By
late August, the Hanover unit was running
short of almost all the stores it required,
especially medicines, and the number of
patients was so great that eight or nine
buildings, some of them containing as many
as eight rooms, were taken over. Untrained

Defeat to Victory: June 1778-1783

121

 

JAMES MCCLURG. (Courtesy of National Li-
brary of Medicine.)

soldiers, here as elsewhere, were pressed into
service as nurses. In September, as prepara-
tions for the siege of Yorktown increased,
the physician at the Hanover hospital him-
self died and the responsibility for the care
of his fellows fell entirely upon one of the
patients.??

A combined American and French force
of 15,000 men was in place at Yorktown
by the end of September, under the overall
command of General Washington. Three
or more hospitals were opened at Williams-
burg, where Director General Cochran re-
ported a total of 250 patients, and in York-
town flying hospitals for both French and
Americans settled down with the armies for
the siege, the Continental unit under Craik’s
direction since Cochran had remained be-
hind along the banks of the Hudson. Not
all department reports identify the location
of flying hospitals, but one report which
still exists without question originated from
the American Yorktown flying hospital. It
is dated October 1781 and does not record
the number of admissions and discharges,
122

§ =

THE ARMY MEDICAL DEPARTMENT,

1775-18138

 

COLLEGE OF WILLIAM AND MARY: WREN BUILDING. (From Duncan, Medical Men.)

but it lists 6 dead and 147 convalescent,
209 with intermittent fever, 103 with diar-
rhea, and 646 remaining at the end of the
month.%

In Williamsburg, the French took over
the building belonging to the College of
William and Mary which they, in contrast
to Rickman, considered well suited for a
hospital. They were particularly impressed
with its size and sturdy construction, but
in time found it necessary to take over the
Capitol as well. Before they returned the
college to its owner, one wing burned down.
The Americans used the palace, which was
not in good condition, and two churches to
house their sick and wounded. A 200-man
detachment from the forces besieging York-
town stayed behind to guard hospitals and
the stores left in Williamsburg while the
main army moved against the British.%*

Casualties for the allied armies during
the siege of Yorktown were not great, but

sickness, particularly malaria, took a heavy
toll and an epidemic of smallpox was antic-
ipated. The French experienced a rate of
disease in their hospitals no better than
that of the Americans even though their
military hospital organization was elaborate
and their physicians so much respected that
Continental doctors were glad to have their
aid and advice. Tilton blamed poor sanita-
tion and a tendency to avoid the use of the
medicines, including opium, popular among
American physicians, for the limited suc-
cess of French units.%

Early in the siege of Yorktown, the num-
ber of patients in American hospitals in the
area rapidly increased. New England troops,
especially, were suffering from the remittent
and intermittent fevers considered endemic
in that area. Craik noted that blankets were
in short supply and that, unless action were
taken at once, an unnecessarily high mor-
tality rate could ensue. At the time of the
Ch. 5]

British surrender, 600 Americans were too
sick or too severely wounded to be cared
for by camp hospitals, approximately 400
of them at Williamsburg and more than 200
at Hanover. Thacher estimated that seventy-
three Americans were wounded during the
siege.

AFTER THE VICTORY AT
YORKTOWN

From November 1781 to the end of the
war, an unofficial truce prevailed through-
out the colonies. General Washington re-
mained near New York City until the end
of the war, while General Greene set up
camp near Charleston, South Carolina, un-
til the summer of 1783, when the last of
the Southern Army left for home.®7

The number of patients resulting not
only from battle but also from the malaria-
ridden environment was increasing at such
a pace that even before the Articles of
Capitulation were formally signed, General
Washington himself was active in the at-
tempt to find additional hospital space.
He wished as many as possible to be cared
for within the town of Williamsburg and
emphasized the need for separate housing
for those who came down with smallpox
while in the area. He was distressed by
conditions in the Army’s hospitals there
but apparently believed that captured funds
would now make improvements possible.
As soon as the Articles were signed, the
general prepared to move his army out of
the unhealthy climate as quickly as possible.
The transports which were being loaded
before the month was out sailed 4 No-
vember, but a sufficient number of officers
was left behind to escort patients back to
their units as they recovered.?®

At the end of November 1781, 186 pa-
tients were still at Williamsburg, 23 of
whom were suffering from smallpox and 49
each from wounds and dysentery. At Han-
over there were another 114 patients who

Defeat to Victory:

June 1778-1783 123
could not accompany the army when it
moved north. Only 74 remained at Williams-
burg and 32 at Hanover by the end of De-
cember, however. There is some question as
to which physician was in charge of the
Williamsburg hospitals at this time and no
evidence to indicate who had charge of the
Hanover facility. Apparently both Tilton
and Treat directed the Williamsburg units at
one time or another during or after the
siege, but it seems likely that Treat, who
was a Chief Physician and Surgeon of the
Hospital at this time, held overall authority
in Williamsburg during the siege and that
Tilton, as a Hospital Physician and Surgeon,
succeeded Treat.%?

Despite General Washington's hopes, the
sufferings of the patients in Williamsburg
continued unabated after the siege, not only
because of the lack of such fundamental
items as wood and straw for bedding but
also, in the opinion of at least one observer,
because the surgeons there behaved in an
irresponsible manner, failing to make the
required purchases even when they had the
money to do so. In December, matters were
made even worse by a disastrous fire which
burned the palace to the ground. Fortu-
nately, there was only one casualty and the
French took in those who would otherwise
have been without shelter. In January, fifty-
five Continental soldiers, nineteen of whom
were wounded, were still hospitalized at Wil-
liamsburg. At last, in the spring of 1782,
General Washington decided that there were
so few patients remaining at Williamsburg
that he could have the facilities closed.

After the Yorktown victory, General
Greene moved southeast toward Charleston.
His men had been in poor health since the
engagement at Eutaw Springs a month
earlier and now many had to be left behind
at the hospital in the High Hills of Santee
under the care of Fayssoux. A second hos-
pital was maintained at Charlotte, North
Carolina, in late 1781 and early 1782.19

Many of the units which had been sur-
124

rounding Yorktown, including those of Gen-
eral Wayne and Maj. Gen. Arthur St. Clair,
were now sent south to join General Greene.
These men were also in poor condition and
inadequately fed and clothed. Some, at least,
maintained themselves in good spirits by
whatever means presented themselves, re-
peated references in at least one journal to
the dire state of the author’s health being
followed by repeated references to “last
night's carouse.” As these troops neared
Charleston, they came upon an area of very
bad water with many stagnant swamps and
ponds “full of little insects.” 1°2

When the troops of Generals Wayne and
St. Clair reached the vicinity of General
Greene’s camp near Charleston early in Jan-
uary 1782, many were sick enough with
fever to require hospitalization at the fa-
cility which had been established at Ashley,
apparently in a private home. Although its
physicians were “very kind” and it was
“furnished with some stores, sugar, tea and
molasses,” the Ashley hospital was reputed
to be a “very disagreeable place—all sick,
and some continually dying.” By March,
although the health of the Southern Army
had markedly improved, talk of mutiny was
being heard.1%3

The journals kept during the spring and
early summer of 1782 suggest that many of
the men of the Southern Army did not
lightly turn to physicians and hospitals for
aid. The author of one account, for example,
mentioned in his entry of 28 May 1782 that
he was “loaded with sickness and distracted
with toothache . . . almost dead with pain.”
He continued to make similar complaints
for more than ten days without ever sug-
gesting that he was seeking professional help,
and on one occasion, apparently on his own
initiative, took “a vomitt which almost
killed” him.104

During the summer of 1782, General
Greene's men again began to suffer from
fevers, just as they had in previous summers,
and matters grew worse as the summer

THE ARMY MEDICAL DEPARTMENT,

1775-1818

progressed. By the end of August, they were
“dayly experiencing instances of mortality

. , soldiers dying fast,” the hospital was
crowded, many were sick at camp, and
deaths were so frequent that funeral cere-
monies were no longer conducted. By the
second week in September, it was estimated
that more than half of the men remaining
in camp were ill, although there appears to
have been at least some bark available.10%

Treating oneself apparently continued to
be an accepted practice in the fall of 1782.
In one instance, for example, the victim’s
fever and aching began on 29 September.
He first tried treating himself on the 30th,
using an emetic. Still feverish on 2 October,
he started taking bark and within the week
felt very much better. He suffered a relapse
ten days later, however, and again tried an
emetic before turning to bark because of
the “violent fever and pain” in his “head
and bones.” The fever returned once more
for two days in mid-November, but the
diarist unfortunately did not record his
treatment on this occasion.!%¢

This “cursed disorder,” presumably ma-
laria, which was still severely affecting the
Southern Army in the autumn of 1782, led
to the deaths of almost 100 men in Sep-
tember. Characterized by “ague and fever,”
it was blamed not on insects, despite the
fact that their presence had been the sub-
ject of comment, but on the climate. Gen-
eral Wayne himself fell victim to it early
in September and was treated with emetics
and peruvian bark. He was still ill at Christ-
mas and wrote Dr. Benjamin Rush that he
was “broken down and nearly exhausted”
as a result.107

In December, the British evacuated
Charleston and, although General Greene
remained there until the following August,
the number of men in his command began
to diminish. The Secretary at War ordered
at the time that they be furloughed until
peace was officially signed and some units
were granted leave at once. Transportation
Ch. 5]

difficulties interfered with the departure of
others, and since it was July before the
units from Pennsylvania and Maryland
boarded their ships, the diseases which
characterized the summer months in the
South appeared again. One-third of those
who were awaiting transport to their home
states that summer were ill.1%8

There had been rumors during the siege
of Yorktown that the British were trying
to infect the Continental Army by sending
out from the town ‘“a large number of
negroes, sick with the smallpox.” Whatever
the truth of the matter was, by January
1782, smallpox was spreading in the Conti-
nental Army in the North, and it was
decided once more to inoculate all those
who had not already had the disease. By the
end of the month, approximately two
thousand men had been immunized, and by
May the process was complete.10?

To care for men returning north from
Yorktown who might become ill along the
route and be unable to continue because
of the winter weather, temporary hospitals
were established along the route from Vir-
ginia northward. One such unit, at Head of
Elk, Maryland, was opened no later than
22 November 1781. During December, 118
patients were admitted here, but only 38
remained at the end of the month, 60 hav-
ing been discharged and 2 having died. Dr.
Henry Latimer set up another such unit at
Wilmington, Delaware, and 105 patients
were admitted during December, of whom
23 died and 35 remained at the end of the
month. General Washington decided to have
the Head of Elk patients moved there, and
late in January, thirteen convalescents from
Head of Elk were moved to the Delaware
unit. In February, plans were laid to move
these patients and those at Trenton to
Philadelphia.1?

Upon their return from Virginia, the
physicians of General Washington's army
set up their flying hospital at New Windsor,
New York. At some time before the fall

Defeat to Victory:

June 1778-1783 125
of 1782, Dr. David Townshend became
director of this unit. Regimental surgeons
were required to report to him weekly
about their patients and to receive their
bandages and ointments from him. Obtain-
ing wood was a constant problem here, and
as early as 9 December 1781, patients were
suffering as a result of the inadequate sup-
ply.111

Director General Cochran recorded that
at the end of December 1781 there were
239 patients, including 25 women and chil-
dren, in the New Windsor huts. Of this
number, 27 were convalescent, 29 suffering
from “ulcers,” 23 from inflammatory fever,
27 from intermittent and remittent fevers,
and 36 from diarrhea or dysentery. By the
end of January 1782, however, the number
of patients had dropped to 187, remaining
below 190 until June 1782. In June and
July, however, the number of patients again
rose to 225 or more, with 38 of the men
suffering from venereal disease, apparently
the most common ailment at this time, al-
though many cases of the various types of
fever could also be found.!!?

The hospital at the New Windsor huts
continued in operation at least until the
end of December 1782, when the last of
Cochran’s reports which are still in existence
was made up. By the last two months of the
year, the patients were numbering well over
200, and as many as a quarter of them at
any one time might be women and children.
The incidence of malarial type fevers fell
off rapidly until none was listed in the
September, November, and December re-
ports (there is no report for October), but
“inflammatory fevers” afflicted thirty-three
patients in the last two months of the
year.118

Because of the rather casual use of
nomenclature and the equally casual attitude
toward reports, it is difficult from the docu-
ments of the period to separate one flying
hospital from another and flying hospitals
from regimental hospitals. In his report of
126

November 1781, for example, Cochran lists
a flying hospital with the Eastern Army.
Although it was obviously not the unit at
New Windsor, no identification of it is
available. In November, however, 17 were
admitted to this unit, 24 were discharged,
2 died, 35 were sent to the general hospital,
and 84 remained at the end of the month.
The report of March 1782 lists “sick with
the army,” which was then broken down
into two categories, the army at West Point
and the army east of the Hudson. At the
former, 100 were confined with smallpox,
presumably, considering the time of the
year, from inoculation, and forty-two with
bilious fever. Eight died during the month
there and 345 remained. East of the Hudson
there were 35 patients with smallpox, 26
with bilious fever, 171 convalescents, and
367 remaining at the end of the month.
February of 1782, however, was the busiest
month for the hospital serving the army at
West Point. During this month, 1,149 were
admitted, and although 1,002 of these had
smallpox, there were only 39 deaths. In
the spring of 1783, an epidemic of measles
struck the West Point area and General
Washington urged that fresh meat, which
was considered desirable for victims of this
disease, be procured. The West Point unit
was still in operation late in 1783.114

The total remaining sick with the Army
at the end of each month throughout the
year ranged from 370 in May to a high of
729 in July, when 216 were sick with inter-
mittent and remittent fevers. Other diseases
in the last eight months of 1782 were bil-
ious and putrid fever, which hospitalized
as many as 90 patients in the late summer
before tapering off as the fall wore on to
November’s 34 and December’s 26. As
many as 170 men might be placed in the
category of “casual hurts” each month.115

It was during the winter of 1781-82 that
Cochran and Craik appear to have given
some thought to improving the equipment
of the Continental Army’s flying hospital.

THE ARMY MEDICAL DEPARTMENT,

1775-1818

They decided that dimensions of 15 feet
by 26 feet were the most suitable for the
tents which the hospital apparently used
while the army was on the march. They
should also either “have fly’s to them” or
“be made of the best stuff.” Their idea
pleased General Washington, who passed it
on to the Secretary at War.!1¢

It is difficult, however, because of the
relatively imprecise information given by
eighteenth century documents, to be sure of
the number and type of the hospitals in the
vicinity of General Washington's army after
the Yorktown victory. One unit is listed
as located at New Boston on the Hudson
River and, according to some sources, under
the direction of Eustis in December 1782.
Thacher, however, also mentioned that both
Townshend and Eustis were at the New
Windsor hospital in December 1782. Eustis
himself wrote of being Hospital Surgeon at
New Boston in the autumn of 1782. Gen-
eral Washington referred in November 1782
to “the Hospital of Dr. Eustace,” thus dis-
tinguishing it from Townshend’s unit, but
did not further identify it.117

The returns submitted by Director Gen-
eral Cochran in the last half of 1782 called
the New Boston unit the “New Boston
huts,” where the August 1782 population
of 216 gradually dwindled to 34 at the end
of December 1782. The number of wounded
here was always small, no more than four
according to the records available today,
but in the summer, fevers of both the inter-
mittent-remittent and bilious-putrid types
accounted for a large proportion of the
sick, almost half in August. General Wash-
ington was particularly concerned about the
fuel supply for Eustis’s unit, presumably
New Boston, as the winter of 1782 ap-
proached, but believed that it could be kept
adequately supplied because no more pa-
tients were being sent there.118

Several of the oldest general hospitals
in the department’s organization were still
in operation when General Washington’s
Ch. 5]

victorious army left Yorktown. The hospital
at Trenton, New Jersey, for example, was
still in operation as General Washington's
men made their way north. Cochran re-
corded 72 American patients and 23
British prisoners at Trenton at the end
of November and 38 Americans at the end
of December.!?

The number of patients at the depart-
ment’s Philadelphia hospital, already rising
before the battle of Yorktown, reached a
peak of 314 in November 1781. Only 30
of these men were listed as wounded, how-
ever, while 43 had inflammatory fevers, 40
diarrhea, 52 “various chronic,” and 63
smallpox. Early in December, there were
approximately 100 smallpox patients at
Philadelphia, although no differentiation was
made between those who had acquired the
disease by inoculation and those who had
contracted the disease naturally. The patient
load decreased markedly, to 107, in Decem-
ber 1781 and vacillated between 94 and 146
until June, when only 68 patients remained.
Bilious-putrid fevers do not appear to have
posed a serious threat in the winter and
early spring of 1782, although other fevers
afflicted from a quarter to a half of the
patients there. This unit was apparently
sufficiently crowded in the spring of 1781
to cause the Hospital Department once more
to contact the privately run Philadelphia
Hospital to request the use of its facilities
for Continental patients and sick British
prisoners, but the appeal was denied.120

The total number of patients remaining
at the military facility in Philadelphia con-
tinued to be less than 100, except for Au-
gust, and until late fall a sizable proportion
was afflicted with intermittent and remittent
fevers. Women and children at that time
formed a third of the facility’s patients. Sick
British prisoners were a responsibility of
the department in Philadelphia throughout
1781 and 1782, and their number ranged
from twenty-eight to seventy. Reports con-
cerning them are less detailed, however,

Defeat to Victory: June 1778-1783

127

than those on American patients in Phila-
delphia, and in many reports they are all
lumped together under the heading “various
diseases.” Despite the strain on the Phila-
delphia unit, it was only in 1783 that the
department was successful in placing some
of its patients in Philadelphia’s civilian fa-
cility.12!

The Albany unit, like that in Philadelphia,
was still open when the Hospital Depart-
ment was disbanded, even though its closing
had been ordered two years earlier. In No-
vember 1781, fifty-four patients were at
Albany. This unit seems to have been closed
early in 1782 and then reopened in the
spring, since forty-five patients were re-
ported to be there in May. From forty-four
to fifty-four patients, as many as half of
whom might be women and children, were
cared for at Albany through November
1782, beyond which time there apparently
are no further reports still in existence. The
staff there in late 1783 consisted of one sur-
geon and his mate.!2?

By the spring of 1782, General Washing-
ton had come to regard the continued oper-
ation of the general hospital at Boston as
an unjustifiable expense, especially since the
Corps of Invalids was no longer stationed
there. As a result, the general ordered
Cochran to close that facility at once.123

Although there was no major action after
the victory at Yorktown and Congress had
forced the closing of some of the major
hospitals even before the end of 1781 (see
Chapter 2), the concern of General Wash-
ington and, until its termination in the fall
of 1783, of the Hospital Department for
those soldiers who were still suffering from
wounds and sickness did not diminish. The
general continued to inspect such hospitals
as still remained open and to urge that
they be “amply Supplyed with Medicines,
refreshments and accomodations.”!2* Even
under the adverse conditions of the last
two years of the Revolution, therefore,
there were patients for whom the Hospital
128 THE ARMY
Department was still responsible who could
praise “the humane treatment and com-
fortable accommodations they . . . invari-
ably experienced.” 12°

In 1783, although they did not realize
it, physicians were unable to offer their
patients anything better than humane treat-
ment and comfortable accommodations. Al-
though the often cold, half-starved, poorly
clothed men of the Continental Army suf-
fered more from discase than did their
disciplined and seasoned opponents, eight-
eenth century medicine was everywhere
helpless against disease and infection and
had little to offer against pain. The time had
not yet come, furthermore, when an under-
standing of the importance of scientific ob-
servation to medicine would make it pos-
sible for those physicans who cared for the

MEDICAL DEPARTMENT,

1775-18138

victims of war, regardless of the army in
which they served, to contribute significantly
to the progress of medical science. Ad-
ministrators may have learned much about
the management of a military hospital sys-
tem in the course of the Revolution and
individual surgeons undoubtedly added to
their skills while confronting diseases and
injuries which they would never otherwise
have encountered in such numbers, but no
significant insights into the prevention,
diagnosis, or treatment of disease appear
to have resulted from the American Revo-
lution. Indeed, although they did not know
it, physicians would continue for many
decades after the signing of the Peace of
Paris to be unable to offer their patients
anything of a value to rival that of their
compassion and concern.
6

Between Wars, 1783 to June 1812

The period between the end of the Revolu-
tionary War and the spring of 1812 was
a low point in the history of the medical
service of the U.S. Army. The very con-
cept of a regular standing army was suspect
to the leaders of the new nation, who be-
lieved that the Army should be strictly
limited to as small a force as was compatible
with the protection of westward moving
settlers and the magnitude of the threat
from abroad. Much reliance was placed
upon militia and volunteer units which were
employed as more appropriate to the de-
fense of a republic than the Regular Army.
A force of as limited numbers as that initially
maintained in this period did not require
the establishment of a formal medical de-
partment, and, indeed, there were no top
management posts in the Army at this
time.!

The strength and organization of the
Army, however, fluctuated with the threat
to the nation as perceived by its leaders.
The resultant instability was increased by
the inadequate size, organization, and leader-
ship of the Department of War, which was
created in the summer of 1789. Despite the
fact that three Secretaries of War in the
interwar period, Henry Dearborn, James Mc-
Henry, and William Eustis, were physicians
and that the number of men actually in
the Army had greatly increased by 1794,
no central organization was established for
the medical services. (Table 7) Even for
those brief periods before 1812 when laws
calling for a central organization were on
the books, the medical department, like

the Army itself, existed largely on paper.
(See Appendix H.)

The organization created on paper by the
legislation of 1799, a medical department
for both Army and Navy, indicated
that the lessons of the Revolution had not
been entirely lost. A purveyor, for example,
was specifically called for, to handle the
buying of medicine and the other require-
ments of the projected department, and the
regimental surgeons were fully under the
control not only of the physician-general, or
head of the department, but also of the
senior hospital surgeon of an army or dis-
trict. The relationship of medical officers
and line officers was in some instances
carefully outlined. A regimental surgeon
could be temporarily reassigned away from
the care of the patients of his regiment, for
example, only by the physician-general or a
senior hospital surgeon with the consent of
the commander-in-chief or of the com-
mander of an army. In addition, the rules
which the department was to draw up for
hospital discipline and camp sanitation were
to be subject to the approval of the com-
mander-in-chief or the commander of a
separate army or district as well as, ulti-
mately, to that of the President of the
United States. Provision was also made for
the calling of medical boards to examine
candidates for positions within the depart-
ment, but the establishment of these boards
was to be at the discretion of the physician-
general.? (See Appendix H.)

Initially it was only the constant threat
of Indian attack that made the maintenance
 

 

130 THE ARMY MEDICAL DEPARTMENT, 1775-1818
TABLE 7—ORGANIZATION OF MEDICAL SUPPORT OF THE REGULAR ARMY, 1784-1813
Date Regular Army Medical Personnel
1784, June: All but 80 men from Continental ..

1785, April:
1789, August:

September:

1790, April:

1791, March:

1792, March:

December:

1794, May:
1796, May:

1798, April:
May:

July:

1799, March:

1800, May-June:

1801, March:
1802, March:

 

Army to be discharged

700 men called up from state militias
to form regiment for 1-year service

700 men called up from state militias
for 3-year service

1 infantry regiment: to consist of 560
men

1 artillery battalion: 280 men. Dept.
of War established

Army’s organization accepted under
new Constitution

Infantry regiment expanded: to in-
clude 1,216 enlisted men and non-
commissioned officers

Second infantry regiment authorized:
912 more men

3 more infantry regiments authorized,
plus 1 squadron light dragoons

Army reorganized into form of Le-
gion: composed of 4 sublegions,
1,280 men in each

Corps of Artillerists and Engineers
established: 4 battalions

Legion organization abolished: Army
reorganized into 4 regiments of
infantry, 2 companies of light
dragoons, and the Corps of Ar-
tillerists and Engineers

Second regiment of Artillerists and
Engineers authorized

Increase in size of Army up to 10,000
men authorized

12 infantry regiments authorized; 1
dragoon regiment created

Additional 24 infantry regiments au-
thorized, as well as 3 cavalry regi-
ments, another battalion of Ar-
tillerists and Engineers, a regiment
and a battalion of riflemen

All but 4 infantry regiments, 2 regi-
ments of Artillerists and Engineers,
2 troops of dragoons, to be mus-
tered out

Army reduced to 2 infantry regi-
ments, 1 artillery regiment

 

1 surgeon, 4 surgeon’s mates
1 surgeon, 4 surgeon’s mates

1 surgeon’s mate

1 surgeon, 2 surgeon's mates for in-
fantry regiment; 1 mate for artillery
battalion

Ratio of 1 surgeon and 2 surgeon’s
mates per regiment maintained,
but President may take on more
mates

1 surgeon, 2 surgeon’s mates per
regiment, plus a surgeon’s mate
for the dragoons

1 Surgeon-General for the Legion plus
1 surgeon and 3 surgeon's mates
per sublegion and 6 mates for garri-
son duty

1 surgeon, 4 surgeon’s mates

For each regiment, 1 surgeon, 2
surgeon’s mates; no medical attend-
ants for dragoons; 1 surgeon, 4
surgeon’s mates for Corps of Ar-
tillerists and Engineers; up to 10
more surgeon’s mates could be
appointed by the President

1 surgeon, 3 surgeon’s mates

President authorized to appoint a
Physician-General if he believed it
advisable, to serve until dismissed
by President

1 surgeon, 2 surgeon’s mates per regi-
ment: more if President believed it
advisable, to serve until dismissed
by President; James Craik ap-
pointed Physician-General

Medical Department created by Act
to Regulate the Medical Establish-
ment 2

Each regiment, regardless of type, to
have 1 surgeon, 2 surgeon’s mates

Only 6 surgeons and 12 surgeon's
mates retained in Army; Craik
mustered out

Only 7 mates still in Army

2 surgeons and 25 surgeon's mates
authorized, all to be attached to
garrisons and posts
Ch. 6]

Between Wars: 1783-June 1812

TABLE 7—ORGANIZATION OF MEDICAL SUPPORT OF THE REGULAR ARMY, 1784-1813 —Continued

 

Date

Regular Army

Medical Personnel

 

1807, December:

1808, April:

1812, January:

18 June:

26 June:

1813, January:

 

Army of 9,900 authorized, to include
3,300 already serving

Increase of 10 infantry regiments, 2
artillery regiments, and 1 dragoon
regiment authorized

When war declared, authorized
strength of Army was 35,603 men
in 17 infantry regiments, 4 artillery
regiments, 2 dragoon regiments, a
Corps of Engineers, and 1 regiment
of riflemen

Army reorganized: size of infantry
regiments set at 900 men and au-
thorized number of infantry regi-
ments raised to 25

Raising of up to 20 more regiments
authorized

 

2 surgeons in Army, only 1 on duty;
31 surgeon’s mates, only 27 on duty

Addition of 5 surgeons, i5 surgeon's
mates for hospitals, plus 1 steward
and 1 wardmaster per hospital au-
thorized

Ratio set of 1 surgeon, 2 surgeon's
mates per regiment of any type plus
hospital surgeons and mates as
needed and 1 steward per hospital

Each infantry regiment to have 1
surgeon, 2 surgeon’s mates, dragoon
regiments 1 surgeon's mate each

Each new regiment to have 1 surgeon,
2 surgeon’s mates

 

Note: For actual strength of Army, see Weigley, Army, p. 566.

Sources: Emory Upton, Military Policy of the United States (Washington: Government Printing Office, 1904) pp. 69, 75-76,
78. 80, 82, 83, 85-86, 89: U.S. Congress, American State Papers: Documents, Legislative and Executive of the Congress of the

131

United States. Class V: Military Affairs, 7 vols. (Washington: Gales and Seaton, 1832-61), 1: 5, 40-41, 154-55; Callan,

Military Laws, pp. 212-13, 230, 238; Weigley, Army, p. 118.

4See Appendix H.

of any regular military force acceptable.
Periodic expeditions with small numbers of
regulars and their surgeons serving as a
nucleus for larger numbers of untrained
militia and volunteers were sent into the
Northwest Territory to forestall large-scale
Indian attacks. Forts were also established
to protect the settlements going up in these
areas formerly held by the Indians. In
time, however, the defeat of poorly orga-
nized campaigns such as those of Brig. Gen.
Josiah Harmar in 1790 and Maj. Gen.
Arthur St. Clair in 1791 led to increases in
United States military strength which, be-
cause of the growing fear of war with either
France or England, were maintained even
after Maj. Gen. Anthony Wayne's defeat
of Tecumseh and the Shawnee Indians at
Fallen Timbers in 1794.3

As the threat from France waned, the

Indian menace once more became upper-
most among the Army’s concerns, although
the northwestern campaign of Maj. Gen.
William Henry Harrison against the Shawnee
in 1811 was the only active move against
the Indians after 1800 and before the War
of 1812. In 1802, the organization of
medical support was changed to center it
around the garrisons which were now being
established as a line of defense along the
nation’s perimeters. The President, after
congressional approval, assigned surgeons
and mates by fort rather than by regiment.
To meet the new approach, the number of
mates was increased, but it was not until
1808 that the need for physicians other
than garrison surgeons was recognized and
a plan was created which authorized the
assignment of both medical and administra-
tive personnel specifically to hospitals. Ap-
 

 

 

1783-1811
100

MILES

 

2.
@.
.
©
=
3

   

2,
0,
<9.
PD,
%
©.

 

 

ILLINOIS TERRITORY

  

NORTHWEST TERRITORY

  
   

  
 

INDIANA TERRITORY

 

Vincennes

Terre Haute/Fort Harrison

MICHIGAN TERRITORY

Detroit

Toledo

a Clair's defeat OHIO

Tippecanoe | 0

Greenville/Fort Jefferson

Sena Fort Washington

KENTUCKY  \_

Fort Knox

Note: Boundaries indicated here are as they existed in 1811.

  
 

   
   
 
 
  
 
 

N
>

7

  
 
  
 
     
     

  

VIRGINIA

 

 

MAP 9

 

zel

‘LNEWN1Y¥Vda(Qg TVOIAAW AWHY dH]

8I8I-SLLI
Ch. 6]

parently only one hospital surgeon and one
hospital mate were actually appointed at
this time. It was only six months before
the outbreak of war that provision was
once again made for the assignment of
surgeons and mates directly to individual
regiments.* (See Table 7.)

The prestige of the military surgeon at
this time could not have been high. He still
had no official rank and was paid a salary
lower than that of major. Lewis and Clark
apparently did not consider the services of
a surgeon to be necessary for their famous
expedition to explore the lands beyond the
Mississippi River, and only two years before
the beginning of the War of 1812, a group
of surgeons complained to the Secretary
of War that they were “the mere menial
drudges of camp.” ®

CONTINENTAL ARMY
PATIENTS REMAINING IN
HosPITALS

After the peace treaty of 3 September 1783
brought the formal end of the American
Revolution there was no further reason to
delay the final closing of those hospitals
which were still caring for patients from
the Continental Army. Presumably the
medical board which was formed in the
summer of 1782 to decide whether to trans-
fer the “invalids and debilitated men” re-
maining in the Army to the Invalid Corps
or to discharge them from the Army, as
well as to determine their eligibility for a
pension, continued in operation until all
in this category had been processed. For a
time, however, the remnants of the Conti-
nental Hospital Department functioned as
a peacetime organization dedicated to the
care of these men at West Point, Albany,
and Philadelphia. In the summer of 1783,
however, Gen. George Washington predicted
that it would be possible to close this estab-
lishment completely by the following sum-
mer. The staff of the former Hospital

Between Wars: 1783-June 1812

133

Department was gradually dismissed as the
need for its services diminished.® Since, ex-
cept for fewer than 100 men assigned to
guard stores and magazines at such places
as West Point and Fort Pitt, the men still
remaining in service from the Continental
Army were dismissed on 2 June 1784, one
can only assume that by this time all former
Continental Army patients, including those
in the Corps of Invalids, had also been dis-
charged.

CAMPAIGNS AGAINST THE
INDIANS

The first major operation involving the U.S.
Army was that led by General Harmar in
1790 against the Indians in the Northwest
Territory, near present-day Fort Wayne,
Indiana. (Map 9) At this time the Army
consisted of one infantry regiment, to which
was assigned a surgeon and two mates,
and an artillery battalion with its surgeon’s
mate. (See Table 7.) Serving as the Army’s
top physician was Dr. Richard Allison, of
whom a contemporary said, “none were
more brave, humane, and benevolent.” 7
Allison was assisted by surgeon’s mates
John Elliott and John M. Scott, while the
mate assigned to the artillery battalion was
Nathan Hayward. Little is known of the
medical care received by the 320 regulars
who accompanied the 1,100 militia men
on this expedition, but the sick rate was
high and Allison complained long before
the campaign began that the medicines pro-
vided for his use constituted an “injudicious
assortment” of “the refuse of the druggists’
shops” and were of such poor quality that
he was unable to determine proper dosages.®

The governor of the Northwest Territory
during this period was Arthur St. Clair. In
1791, St. Clair was assigned the rank of
major general in the Army, which had been
enlarged for a second attempt to subdue
the Indians in the Northwest. It is interesting
to note that General St. Clair, like so many
134

 

RICHARD ALLISON. (Courtesy of National
Library of Medicine.)

other men in prominent positions with the
Army at this time, had had some medical
training. Among the members of his ex-
pedition who served as physicians were Al-
lison, as chief surgeon, and Elliott, who
continued to function for a time as Allison’s
mate and then, with Allison’s full approval,
was promoted to surgeon of the 2d Regi-
ment. This latter post had first been offered
to Eustis who, destined for greater things,
turned it down. Among other medical at-
tendants was Victor Grasson, a surgeon’s
mate attached to a volunteer unit.’

General St. Clair’s force of 1,500 militia
men and volunteers and 600 regulars was
larger than that of his predecessor, but the
general himself was in poor health and so
badly afflicted with gout that he could not
walk without aid. Before the expedition was
over, he was unable to so much as mount
his horse without assistance. His men, fur-
thermore, were ‘badly clothed, badly paid
and badly fed.” Since they were for the

THE ARMY MEDICAL DEPARTMENT,

1775-18138

most part recruited from cities and large
towns, they were also reputed to be “ener-
vated by idleness, debaucheries, and every
species of vice.” 1°

By the fall of 1791, General St. Clair’s
surgeons were faced with severe problems.
Hospital stores, particularly wine, were in
very short supply and the number of men
who were sick had risen so high that the
general decided to remain at Fort Jefferson,
near present-day Greenville, Ohio, until the
end of October, hoping that both health and
supply problems might improve. By the end
of the month, however, when they resumed
their march, 120 men were so ill that they
could not continue any further.!!

Considering the nature and condition of
his force, it is not surprising that on 3
November, General St. Clair was soundly
defeated by the Miami Indians, who attacked
him about thirty miles from Fort Jefferson.
Of a total of 1,400 effectives, 632 were
killed and 264 wounded. Surgeon Grasson
was among those killed, but Allison dis-
tinguished himself in the desperate confu-
sion by aiding the officers in rallying their
men. Even before the battle was over the
Indians were scalping their victims. A
witness noted: “I saw a Capt. Smith just
after he was scalped, sitting on his back-
side, his head smoaking like a chimney &
he asked me if ye battle was not a most
over.” 12

The retreat which followed was so rapid
that those among the sick and wounded
who were fortunate enough to be taken
along by their fellows were deposited at
Fort Jefferson, twenty-nine miles from the
battleground, less than eight hours after the
flight began. Having settled the disabled
there, however, the able-bodied set out
again and reached Fort Washington, where
Cincinnati now stands, on 8 November. The
wounded continued to straggle in to Fort
Jefferson for days after the battle. “Some
soldiers have come in with ye Skin & Hare
taken clean off of their Heads,” an officer
Ch. 6]

Between Wars: 1783-June 1812

135

 

ForT WASHINGTON. (From a drawing by Maj.
Bradley.)

wrote his brother,’® and one had not only
been scalped but also had “a tomehawk
stuck in the head in two places.” 1* Al-
though two medicine chests were lost in the
defeat, every possible effort seems to have
been made to establish hospital facilities and
to obtain all the provisions needed for the
wounded, whose situation was “truly dis-
tressing.” 1%

The failure of two attempts to subdue
the Indians in the Northwest led to a re-
assessment of the approach to the problem.
The leaders of both expeditions were of-
ficially exonerated of any major blame,
which was placed upon the War Depart-
ment, the Quartermaster’s Department, and
contractors. Maj. Gen. Anthony Wayne was
given the Army’s five regular infantry regi-
ments and cavalry and artillery to establish
the Legion for a new effort against the
Indians. General Wayne was also granted
the time to train his men thoroughly near
Pittsburgh before taking them into action,
but although Congress had by this time

Ebenezer Denny, reproduced in Wilson,

authorized a ratio of one surgeon and two
surgeon’s mates per infantry regiment as
well as a mate for the light dragoon squad-
ron, there was only one surgeon actually
with the army when it began its training.!®
(See Table 7.)

General Wayne regarded “the health and
comfort of the soldiers” as “objects of the
first consideration” and was personally con-
cerned with the maintenance of their health
and the proper care of those who became
ill. The general ordered the single surgeon,
Dr. John F. Carmichael, with his men to
begin at once to set up a tent hospital.l?
When, in addition to “a virulent Veneri,”
smallpox broke out, General Wayne ordered
Carmichael to begin inoculating all men who
had never had the disease.!® Shortly there-
after he also ordered Carmichael to locate
“two industrious humane and honest Ma-
trons to assist in nursing and cooking for
the Sick.” Although he had little control
over the shortage of hospital supplies, Gen-
eral Wayne decided to deal with the severe
136

 

ForT DEFIANCE. (Courtesy of Library of
Congress.)

and prolonged shortage of vegetables by
offering the whiskey ration of his men, both
sick and well, to the local inhabitants in
exchange for their produce.'®

Discipline within the hospital also con-
cerned General Wayne even after the arrival
of a second surgeon to help Carmichael. On
at least one occasion, the general was re-
quired to court-martial a sergeant “for
riotiously beating a Woman kept by him as
a Mistress to the injury of the Sick in the
Hospital . . . for abusive language and using
Menancing [sic] words and gestures to
Doctor Carmichael, when requested by him
to desist from the above purpose.” 2°

General Wayne began his active cam-
paign in the spring of 1793, moving first to
Fort Washington (Cincinnati) and then
slowly westward, establishing forts as he
went. He was now accompanied by at least
four physicians, including his chief surgeen,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Allison. As the summer progressed, how-
ever, his men began to fall ill in increasing
numbers, fevers and influenza posing the
greatest problem. Supplies of hospital stores
and medicines were quickly exhausted.
Finally, in desperation, the general ordered
Allison to buy the needed items wherever
he could find them, regardless of price.?!

The decisive action of General Wayne's
campaign against the Indians was the Bat-
tle of Fallen Timbers, which took place on
20 August 1794 not far from the new
British fort near the site of present-day To-
ledo and shortly after the building of Fort
Defiance. The wounded, a total of approxi-
mately 100, eleven of whom later died of
their injuries, were considered fortunate to
be moved from the battlefield in a carriage,
but at least one witness believed that the
evacuation could have been better managed.
“The wounded of the third sub-legion are
under obligations to doctor Hayward for
his attention and humanity to them in this
distress,” he wrote, but “Doctor Carmichael
through neglect had the wounded men of the
artillery and cavalry thrown into wagons,
among spades, axes, picks, &c.” and as a
result, they had to endure “extreme pain,
beside the frequent shocks of a wagon on
the worst of roads.” By 27 August, however,
the wounded had reached Fort Defiance
and were “happily fixed in the garrison, and
the doctors say there is no great danger of
any of them dying.” 22

Even before Fallen Timbers, General
Wayne himself had become gravely ill with
gout; Allison reported him to be “in agony.”
The sick rate among his men, already high
in the early summer, was still increasing
in September, the principal ailment being
“the fever and ague.” An officer explained
that “The number of our sick increase daily,
provision is nearly exhausted, the whiskey
had been out for some time. . . . Hard duty
and scanty allowance will cause an army
to be low spirited, particularly the want of
a little of the wet.” General Wayne may
Ch. 6]

have believed it advisable to trade whiskey
for vegetables, but not everyone agreed
with him; “the troops would much rather
live on half rations of beef and bread, pro-
vided they could obtain their full rations of
whisky” than enjoy the ample supply of
vegetables now available at Fort Defiance.
Unfortunately for the whiskey lovers, how-
ever, their favorite beverage was in very
short supply by that time.2* Shortages con-
tinued until a member of General Wayne's
staff commented of the wounded that “no
set of men in the like disabled situation
ever experienced much more want of con-
veniences &c.” and from time to time the
general still found it necessary to have Alli-
son make purchases on an emergency
basis.’

September was a bad month for malaria
in many areas of Ohio in this period, and
in September of 1795 the number of sick
was again growing rapidly. The burden of
the hospital at Greenville, moved from its
initial location in a blockhouse to huts, grew
from 120 to more than 300 patients in the
space of a month. Patients from General
Wayne's army had been “totally destitute
of any kind of Hospital stores . . . since
last Winter, except a little occasionally
purchased from the Merchants at this place
& Cincinnati in cases of the last necessity.”
Finally the general moved the entire hos-
pital into the open woods in an attempt to
stem the onslaught of disease. Since Allison
was no longer able to find either opium or
peruvian bark in adequate quantity locally,
his surgeons began trying substitutes for
peruvian bark, fearing that if the tide were
not turned, they might soon be facing an
epidemic of putrid fever. October found
General Wayne once again pressing the War
Department for supplies, pointing out that
he was “totally destitute of . . . Medicine &
Hospital stores,” but only in mid-November
did even a portion of the desperately needed
hospital stores begin to arrive at General
Wayne’s camp.28

Between Wars: 1783-June 1812

137

Supply shortages occurred yet again and
to an alarming degree in 1796, at a time
when the number of physicians available to
care for General Wayne's men was also
inadequate. Secretary of War McHenry
seems to have believed this situation hope-
less, for he suggested that the area of
present-day Toledo be abandoned because of
the prevalence of the disease there. The sup-
ply of peruvian bark was exhausted, and in
the garrisons the general had assigned to
posts from Fort Washington to Detroit,
more than 400 officers and men were sick,
most of them with malaria.?” General
Wayne, however, was not required to con-
tend with these problems much longer. His
health had continued poor, and in December
1796, on his way home from Detroit, he
died.

The last campaign against the Indians
in the Northwest to be undertaken before
the outbreak of the War of 1812 was
launched in 1811 when it seemed that the
Shawnees under Tecumseh were becoming
an ever greater threat to settlers. At
Vincennes, approximately 300 regulars and
twice that many militia men were placed
under the command of the Indiana Terri-
tory’s governor, William Henry Harrison,
who was in time commissioned a brigadier
general. General Harrison, who had studied
briefly at the Medical School of the Univer-
sity of Pennsylvania, was another of the
Army’s leaders who had received some
training as a physician.2®

General Harrison established a general
hospital at Vincennes under the supervision
of two physicians from the 4th Infantry
Regiment. The head of this hospital, Dr.
Josiah Foster, was a man whom Harrison
knew and very much admired. Militia units
appear to have, as usual, provided their own
surgeons for this campaign.’

Although during the summer his men
were in generally poor health and suffering
particularly from “bilious autumnal fe-
ver,” 3° in September 1811, General Harri-
138

son moved his men from Vincennes up the
Wabash River to erect Fort Harrison near
the site of Terre Haute, Indiana. At this
time, he ordered that the sick from his
force, many of whom were afflicted with the
painful disease then called “the fever and
ague,” or intermittent fever, be sent to Fort
Knox, where a surgeon’s mate supervised
their care.

By late October, General Harrison was
ready to move directly against the Shawnee
in their village on the Tippecanoe River
near the site of present-day Lafayette, In-
diana. At this time the 900 to 1,000 men
under his command were accompanied by
three physicians, a surgeon, and two mates,
two of whom appear to have been attached
to the Regular Army. The health of the
regulars had improved, but that of the
militia was apparently deteriorating. The
sick, among whom were presumably both
militia and regulars, were left behind at a
small blockhouse built for their use, with a
sergeant’s guard to protect them.®?

The Indians, led in Tecumseh’s absence
by his brother, launched a surprise attack
on 7 November 1811 upon General Har-
rison’s camp near their village, but the level
of discipline which the Americans had at-
tained was such that they were able to
resist the attack and mount a counterattack
of their own which culminated in the
destruction of the Indian confederacy
Tecumseh had formed. General Harrison’s
men suffered total losses of fewer than 200.
Of this number, 37 were killed in action
and more than 150 were wounded, among
whom was a militia surgeon’s mate. Despite
the relatively primitive conditions under
which he was forced to work, among the
operations which Foster apparently per-
formed were two amputations at the
shoulder, a type of surgery not often under-
taken at the time.3?

General Harrisons force returned to
Vincennes on 18 November, moving the
wounded much of the way by boat, but by

THE ARMY MEDICAL DEPARTMENT,

1775-1818

the time they reached that post, the injuries
of twenty-five of them had proven fatal.
By 4 December, three more men had died
in the general hospital at Vincennes and
so many wounds were proving unusually
slow to heal that Foster suspected that the
Indians had used poisoned ammunition. Ex-
amination of the balls found in wounds
revealed that they had been “chewed before
they were insertd into rifles for the purpose
of enlarging the wound and lacerating the
contiguous flesh.” 34

FORTS AND THEIR GARRISONS

The defense policy of the new nation
called for the establishment of forts or
fortifications at strategic points both in
areas where Indians and settlers were likely
to come into conflict and along the coast,
to guard against attacks from European
nations. Among the concerns of the Secre-
tary of War in 1794, for example, was the
completion of fortifications on three islands
in New York harbor, at eight New England
ports, at eleven towns and cities from Phila-
delphia south to Georgia, and at West Point
on the Hudson River.3?

One such coastal fort was Fort Jay, on
Governors Island in the Harbor of New
York City, constructed in 1794 in anticipa-
tion of war with France. A surgeon’s mate
was sent there in the spring of 1802, when
the policy of assigning medical support by
garrison rather than by regiment was adopt-
ed. (See Table 7.) A difficulty which was
by no means unique to the New York City
garrisons arose, however, when the Army
surgeon assigned to the area allowed other
concerns to distract him from his Army
duties. About eight years after this physician
was sent to Fort Jay, testimony at a court-
martial revealed that the only Army phy-
sician then assigned to care for the New
York garrisons was living and practicing
medicine within the city and on occasion
unavailable to these men when they needed
him.3¢
Ch. 6]

Fort Adams on the Mississippi River
south of Natchez seems to have served
as a supply distribution center for lesser
outposts in the area. So important had this
fort become by 1802 that it was assigned
to the care of Carmichael, one of the two
surgeons still remaining in the Army at
that date. Carmichael had previously spent
some time at Fort Adams and was, there-
fore, familiar with the climate and the
problems associated with it. In 1803, a sur-
geon’s mate was sent to work under Car-
michael, a move which could have been
necessitated either by unexpectedly heavy
demands upon Carmichael’s time or by the
fact that this surgeon, too, had found other
duties to keep him busy. He functioned as
a customs collector during part of his stay
at Fort Adams, for example, giving up this
position only in the spring of 1803. The
Secretary of War commented on this particu-
lar occasion, “I trust in the future his whole
attention will be paid to his medical duties.”
By the spring of the following year, however,
Carmichael was preparing to resign.37

The character of the forts in the North-
west Territory varied greatly; some were
simply stockades while others were relatively
complex installations where life was not en-
tirely devoid of luxuries. At Fort Washing-
ton, for example, a physician owned a sum-
merhouse which stood in the midst of the
extensive gardens lying just beyond the walls
of the fort.?8

Particularly detailed records which pro-
vide insight into the work of a garrison
surgeon were left by the surgeon’s mate at
Fort Defiance in Ohio in 1795. Here Dr.
Joseph Gardner Andrews was responsible
for the health not only of the garrison of
approximately 160 officers and men, but
also of a small number of civilians, including
five women and a child. In addition, An-
drews, like other Army physicians during
this period, cared for the ill among neigh-
boring Indians.3?

In the course of fulfilling his duties in

Between Wars: 1783-June 1812

139

1795, Andrews confronted diseases which
were undoubtedly familiar to most of the
surgeons serving with the U.S. Army. On
1 January, he had thirty-seven patients, all
members of the garrison, twenty-five of
whom were wounded. Four of the remainder
were suffering from what he diagnosed to
be rheumatism, three from diarrhea, one
from dysentery, and one from intermittent
fever. A month later, although one of his
earlier patients was dead, the total number
had dropped to twenty-seven, three of
whom were convalescents and fifteen
wounded. By 1 March, the doctor had lost
another patient and a child was among
those listed as sick. By April, although the
child was well again and Andrews’s patients
numbered only twenty-one, intermittent
fever had made its appearance among
them. 4?

Both the total number of patients and
the number with intermittent fever gradually
dropped as spring and summer wore on,
however, despite the fact that in July there
were ‘“‘musketoes plenty” in the area be-
tween Fort Defiance and Fort Wayne. By
late August, Andrews was himself acutely
ill, and by 1 September, all nine of his
patients were sick with intermittent fever.
Ten days later, despite his own condition
and the fact that he had “not a particle of
Hospital Stores,” he was attempting to care
for fifteen patients, all of whom had inter-
mittent fever. Less than a week later, when
he himself still “Had the Ague & fever
extremely severe,” he turned to “the Dog-
wood bark in simple decoction” in an at-
tempt to treat his intermittent fever patients,
who now numbered twenty-one.

The situation as far as hospital supplies
were concerned had come to the attention
of the officers at Fort Defiance, who finally
managed to obtain eight gallons of liquor for
the fort hospital by promising to pay for it
themselves should the government refuse to
do so. By the end of September, Andrews
had also received a keg of wine and 30
140

pounds of brown sugar, items which were
sorely needed by the time they actually
began to arrive. By 1 October, sixty-one of
the total population of Fort Defiance were
sick. Of this number, fifty-eight were listed
as having intermittent fever and three re-
mittent fever. Andrews observed that “The
Intermittents in this place are extraordinarily
rapid in depriving the patients of strength.”
The prevalence of fevers was not limited to
Fort Defiance, 500 having been reported
sick with the two types of fever at Fort
Jefferson.

By 7 October, Andrews was feeling well
enough to pronounce himself recovered, but
two weeks later his fever recurred, fortu-
nately, it seems, for a brief time only. Others
were also recovering at this time, and his
report of 1 November records only thirty
patients, one of whom was suffering from
wounds and two, one of whom died a short
time later, from typhus. By December 1795,
Andrews’s patients numbered only eleven,
two of whom were convalescent and seven
afflicted with “debility.”

Although the Indians Andrews treated
included even a Delaware chief, it was an
American who seems to have caused him
the most trouble. Ensign Frothingham was,
to the surgeon’s great disgust, much given to
treating himself and brought with him to
Fort Defiance “a quantity of medicines, lo-
tions & unguents almost equal to the contents
of my Chest, like a person who has dabbled
sufficiently in medicine to render it a
dangerous tool.” With the aid of an Indian
squaw, this officer “induced a dropsy, or
rather a very dangerous relapse, as . . . he
had the anasarca last year.” Although he at
last promised to follow Andrews’s advice
exclusively, two weeks later, on 6 December
1795, “after a tedious illness wch he did
not endure with that christian fortitude, that
his affectation of religion seemed to induce
an expectation in the minds of his Brother
Officers,” Ensign Frothingham “died . . .

THE ARMY MEDICAL DEPARTMENT,

1775-1818

without a pang.” Andrews stated that an
autopsy revealed that his kidneys had ceased
to function.

WILKINSON IN THE LOUISIANA
TERRITORY, 1809

In 1808, fear of a possible attack by the
British upon the newly acquired Louisiana
Territory led to the assignment of Brig. Gen.
James Wilkinson, another physician who
had abandoned the active practice of medi-
cine and an officer who moved successfully
from one scandal, including the Aaron Burr
conspiracy, to another, to command the
troops to be sent to strengthen the defenses
there.*!

The units assigned to General Wilkinson
in 1809 included three regular infantry regi-
ments and elements of a fourth, in addition
to companies of dragoons, light artillery, and
riflemen, for a total which at times approxi-
mated 2,500 regulars. It is difficult to
ascertain precisely the number and status of
the physicians on duty with General Wil-
kinson’s forces in 1809, but records sur-
viving from this period indicate that among
their number were the surgeons for two or
more infantry regiments and one for a
regiment of riflemen, in addition to a
surgeon and a mate assigned to the general
hospital at New Orleans as hospital physi-
cians; there were probably others there as
well. General Wilkinson, however, believed
that there should have been more physicians
with his men.?

A general hospital was established at
New Orleans to care for the sick of General
Wilkinson’s command, but exactly how
many patients this facility could handle is
not clear. The general maintained that two
empty barracks next to the hospital would
be used to add as many as 500 places to
the hospital’s capacity. During the summer
of 1809, the immediate supervision of this
unit was the responsibility of the hospital
Ch. 6]

surgeon’s mate. The hospital surgeon re-
portedly had a large private practice in the
New Orleans area.*?

As far as the Army’s health was con-
cerned, the situation was building up to
disaster by the spring of 1809 in New
Orleans. General Wilkinson's troops were
undisciplined, his officers inexperienced, and
hospital stores short. In mid-April, only two
surgeons, one of whom was ill himself, and
two mates were actually on duty to care
for the 550 regulars who were ill in the
New Orleans areca, and General Wilkinson
finally believed it necessary to hire private
physicians to help care for his men. Al-
though the fevers which were expected in
the summer in this area had not yet ap-
peared, the health of the men continued
poor, the diseases most frequently seen
being “mostly of the bowels, and ascribable
to a change of diet, and the water of the
Mississippi.” Eustis, Secretary of War at
this time, expressed great concern for the
future health of General Wilkinson’s men
and agreed with him that the Army should
leave the city of New Orleans.**

Although on 30 April, Eustis suggested
that General Wilkinson move his men north
up the Mississippi River to Fort Adams and
Natchez, in the late spring the general
moved them to a location twelve miles
south of New Orleans, on the west bank
of the Mississippi, an area known as Terre
aux Boeufs; he later claimed that he did
not receive Eustis’s communication of 30
April until after the move to Terre aux
Boeufs had been completed.*’

Terre aux Boeufs had a reputation for
pools of water which stagnated long after
a rainfall, but General Wilkinson maintained
that the site he had chosen was a healthy
one with good water. Although he had
found it necessary to order drainage ditches
dug there, he claimed specifically that the
area was dry.4¢

The sick rate at the new campsite con-
tinued very high, although General Wilkin-

Between Wars: 1783-June 1812

141

son, in defense of his decision, pointed out
that Terre aux Boeufs was an improvement
over New Orleans. In an eight-day period at
New Orleans in early June 1809, ten men
died and nine more deserted, but in the last
twenty days of the month, when the army
was at Terre aux Boeufs, only eleven men
died and three deserted. He also stated that
on 14 June, shortly after the move, 565 of
the 1,662 men present at camp were sick,
but that on 27 June, only 429 were sick of
a total of 1,690.47

The summer was a grim one. General
Wilkinson claimed that hospital tents were
set up for each regiment at Terre aux
Boeufs and eventually an eighty-man hos-
pital as well, but, even so, at times the sick
had to remain in their own tents. The supply
of medicines was inadequate and the sur-
geons in attendance were often sick them-
selves. The flour was at times moldy, worm-
infested, and so hard as to challenge an ax.
It was suspected that the general was in
collusion with the contractors who were
responsible for supplying his force.*®

The supply problem was not alleviated,
however, by either the management of Sec-
retary of War Eustis or the custom of
allotting supplies by company without ref-
erence to hospital requirements. Eustis al-
ternated between forbidding the purchase of
the expensive eggs, poultry, and wine physi-
cians wanted for their patients and main-
taining that he could not understand why
all things necessary for the health of the
troops had not been purchased. The general
himself blamed the youth and inexperience
of the contractor’s agent and finally resorted
to the step of authorizing his hospital sur-
geon to buy personally whatever the sick
needed. *?

General Wilkinson did not initially move
his men upstream when he finally did re-
ceive Eustis’s suggestion because, he main-
tained, those familiar with the area told him
that such a move at that time would en-
danger the health of his men. The general
142

stated to Eustis that since the trip would
have to be made by water, it could lead to
the deaths of as many as nine-tenths of his
men. On 22 June, however, Eustis specifi-
cally ordered an immediate move to Fort
Adams and Natchez.?°

Despite General Wilkinson’s misgivings,
the voyage up the Mississippi River was un-
dertaken, albeit not as soon as Eustis wished.
Dr. Alfred Thruston, surgeon for the 7th
Infantry Regiment, had officially protested
the idea of moving the men during the heat
of summer, but in September, the sickest
men having been sent back to the general
hospital at New Orleans, 1,542 men began
the journey. All of them were taken across
the river to the east bank in boats, and then
the 982 men able to do so were put on shore
to proceed north on foot. The remainder,
382 of whom were convalescents still too
weak to march, stayed in the boats for the
entire trip.*!

Although there seems to have been no
lack of both medicines and such staples of
the diet of the sick as tea, sugar, chocolate,
brandy, and wine during the voyage, it was
soon impossible to provide the sick with
proper medical care. Their number multi-
plied rapidly and the boats were soon so
crowded with the ill that the surgeons could
move among them only at night, when camp
was set up on shore.?

The trip from Terre aux Boeufs to Nat-
chez was completed in approximately 45
days. By early October, however, there were
so many ill among the men that two groups
of patients, each accompanied by a physi-
cian, were left off before they reached Nat-
chez. The officers took up a collection to
buy supplies for the hospital which was set
up for 100 patients south of Fort Adams,
and another 120 sick officers and men were
landed at Fort Adams itself. An estimated
300 more men died on the journey.’

General Wilkinson himself, however, was
not with his men for this tragic voyage. At

THE ARMY MEDICAL DEPARTMENT,

1775-1818

the time of the departure, being seriously ill
with “remittent fever, attended with very
violent paroxysms,” he remained at New
Orleans. In November, he set out for Nat-
chez, where a short time later he was re-
lieved by Brig. Gen. Wade Hampton.

It seems reasonable to assume that several
diseases were to blame for the devastation
of General Wilkinson's army in the spring,
summer, and fall of 1809, when at least 500
and possibly as many as 1,000 died. The
surgeon for the Sth Infantry Regiment, Dr.
William Upshaw, reported that the most
prevalent diseases in the early summer were
“chronic diseases, bilious and intermittent
fevers, some cases of scurvy.” The chronic
ailments seem to have been diarrheas, which
were blamed on changes in food and water
despite the fact that some cases predated
the arrival at New Orleans, and a violent
dysentery.5?

General Wilkinson himself noted that the
heat was usually blamed when the number
of sick was high and that although June and
July were wet months, the disease rate
among his men did not peak until later. If
one were to assume that malaria was one of
the principal diseases afflicting the men
along the southern Mississippi River, how-
ever, the late summer peak would not be
unusual. More recent records indicate, for
example, that the number of admissions to
Army hospitals in the continental United
States because of malaria in 1921 was great-
est in August and September and that the
peak month during both world wars gen-
erally came no earlier than July and at times
as late as the early fall.’¢

General Wilkinson and the others con-
cerned with the health of his troops, how-
ever, appear to have had no real suspicion
that mosquitoes were related to the high
disease and death rate in 1809, even though
they did try to protect the troops from
them. In August of 1808, the Secretary of
War suggested to the military agent for
New Orleans the purchase of “a reasonable
Ch. 6]

supply of musquitoe nets for the troops.”
In April of the following year, General Wil-
kinson ordered 100 mosquito bars specifi-
cally for the field hospital serving his sick
and still more for the rest of his men. It was
noted at the time, however, that since the
diarrhea common in his army caused non-
hospitalized men to leave and reenter their
tents frequently in the course of an evening,
mosquito bars did not always solve the
mosquito problem.5?

At least one attempt was made by a sur-
geon familiar with the sufferings of General
Wilkinson’s men to find a single disease
which could be blamed for most of the ill-
ness. Dr. Jabez Heustis chose scurvy as the
culprit, but admitted that not all of the
symptoms he had recorded were those usu-
ally associated with it.

This disease first made its appearance
among the soldiers in the form of an intermit-
ting fever, which, by degrees, assumed a more
malignant aspect, acquiring the character of
the bilious remitting, or yellow fever; becom-
ing more malignant as the season advanced,
and the heat increased. In some instances this
fever was of a violent inflammatory character,
in others, typhoid symptoms marked both its
invasion and progress . . . . Towards the end of
July the epidemic malady appeared among the
troops in a new form, of such an anomalous
aspect, as at first to occasion doubts as to
its nature.%®

Before the more obvious symptoms ap-
peared, according to Heustis, the “features
became sad . . . and the face assumed a
sallow hue.” In time the joints became stiff
“and the tendons in the arms rigid and con-
tracted.” The patient then began to experi-
ence “pain in the parotid glands,” and, in
time, “buboes . . . in the groin,” petechiae,
loose teeth, and bleeding gums. From
this point onward the disease progressed
rapidly, according to Heustis, “destroying
the whole inside of the mouth in twelve
hours, and frequently in less than half that
time.” In one case, a patient was so severely

Between Wars: 1783-June 1812

143

affected that he took “hold of his tongue
. . . deliberately drew it from his mouth, and
threw it on the table, for the contemplation
of his companions.”?*

Heustis was not entirely satisfied with
scurvy as an explanation for the illnesses
which afflicted General Wilkinson’s men.
The symptoms he observed reminded him
in some ways of descriptions of “the East-
ern plague,” which, as he understood it,
was also characterized by enlarged glands,
“feotor of the breath,” buboes in the groin,
and petechiae. Furthermore, he noted,
scurvy was not usually accompanied by
diarrhea and dysentery. Officers did not
often contract this illness, a phenomenon
which Heustis attributed to their custom
of buying fresh food from local inhabitants,
something enlisted men could not afford to
do, but he concluded that “The efficient
cause of this pestilential distemper was un-
doubtedly the use of unwholesome and cor-
rupt provision” such as “old, rancid” pork
and beef which was “poor, lean,” and that
air “highly impregnated with noxious mias-
mata” was undoubtedly a contributing
factor.80

Heustis blamed 1,000 casualties upon the
disease he was attempting to define. He
estimated that 150 of that total had been
“destroyed at Terre-aux-Boeufs,” 250 dur-
ing the journey upriver, and 600 at the new
campsites. He believed, however, that the
chief physician caring for General Wilkin-
son’s men in the Natchez area had con-
tributed to the high mortality rate with his
“injudicious use of mercury, which was
prescribed as a general remedy by the super-
intending physician . . . . A few doses of
this medicine relieved the patient of his
misery, and put an end to his earthly suffer-
ings.” He added that other physicians with
General Wilkinson’s men did not share the
faith of their superior in mercurials and in
his absence omitted his prescriptions in
favor of “vegetable remedies,” such as sor-
rel and wild peppergrass. 5!
144 THE ARMY MEDICAL

MANAGEMENT OF SUPPLIES

Army physicians had no supply system of
their own in this period, and for much of
the time, no physician was directly involved
in the purchasing and distributing of hos-
pital supplies and medicines. Attempts were
made to control the use of these items and
to increase the efficiency of the supply sys-
tem by such steps as establishing separate
lists of medicines to be purchased for south-
ern and northern areas, but complaints of
shortages and poor management continued
to come in from the field, and physicians
were forced to exercise what ingenuity they
could. To augment their supplies of medi-
cines, they turned to such locally available
remedies as the barks of wild cherry, sassa-
fras, willow, and other trees, using them for
conditions ranging from fevers to consump-
tion. It should be noted that in spite of the
fact that it was so difficult to keep its physi-
cians adequately provided, the War Depart-
ment at times permitted some of them to
use government supplies for their own
private patients.%?

Complaints were heard involving both the
quantity and quality of medicines bought,
according to Secretary of War Eustis, by
the “Purveyor of Public Supplies.” Eustis,
apparently determined that something be
done to give a physician a role in the pur-
chasing and distributing of medicines and
hospital supplies, finally turned to Dr. Ben-
jamin Rush for advice. He also asked for
the name of someone who could work with
the men who had the overall responsibility
for purchasing. Rush recommended Dr.
James Mease, who worked at this task dur-
ing the winter and spring of 1810. With
Rush’s aid, Mease composed a list of the
necessary supplies and then personally in-
spected and packed the items to be dis-
tributed to the surgeons.®?

Mease’s services seem to have been ren-

DEPARTMENT, 1775-1818
dered on a temporary basis, for in February
1812, Dr. Francis LeBaron was given the
task of managing the “selection, inspection
and putting up of the medicines and hospital
stores.” LeBaron’s position was not an offi-
cial one, a fact which seems to have very
much concerned him. He urged that Con-
gress create the official position of “Inspec-
tor of Medicine & Hospital Stores,” but by
the end of 1812, nothing had been done
about the matter.%

LeBaron’s duties included the composi-
tion of standardized lists of drug needs and
the solicitation of bids on them from the
leading druggists in Boston, New York, and
Philadelphia. He was also responsible for
constructing and outfitting of medicine
chests, each of which was intended to serve
500 men and to be carried on a baggage
wagon three and one-half feet long.

LeBaron’s center of operations appears
to have been Philadelphia, but he was also
expected to establish storage depots else-
where. On 8 June 1812, a few days before
war was officially declared, he was ordered
to set up a depot at Albany, “for an Hos-
pital Establishment for the Northern
Army.” 68

Throughout the entire period from 1783
to the outbreak of the War of 1812, the
medical support of the units composing the
Regular U.S. Army lay, for all practical
purposes, entirely in the hands of individual
surgeons. Separated from one another by
vast distances, frustrated by shortages of
medicines and supplies, they struggled with
the health problems of soldiers who were
poorly trained, poorly clothed, poorly fed,
and only too often poorly led as well. It
was of physicians caring for the Army’s
sick and wounded under just such circum-
stances, however, that a soldier who had
witnessed their efforts wrote “too much
cannot be said in their praise.” 87
Ch. 6] Between Wars: 1783-June 1812 145

    
    

one Gu? ~ ‘ nr

- Chaban Fools |. Southonn

Gun o Ales fi

Cama.
. Ze Lak.r is dss IE prune oon
v 3 Dlonghts Js. ii
‘ Salo: ae Aa 3

 

 

 

 

 

 

Bol, Gopavwn .. «inns
Here. €o. Sad \
” stud
DS Bulnit:
é6C

 

 

 

 

“ESTIMATE OF MEDICINE, HOSPITAL STORES, ETC. FOR EIGHTY MEN [FOR] ONE YEAR.” (Cour-
tesy of National Archives.)
146 THE ARMY MEDIcAL DEPARTMENT, 1775-1818

YR A
| Hosta, Posts Souham Pots.
| ther 5 270

 

 

 

 

 

®
o
SE
»
N
NN
x 5

A
3
NAN» 2

NEE
*

3
=
+
~ *
*
:

:

{

\
NRNRNR NTNY
EE EY Y EY

 

 

 

Sie. foun. wwe EE te ee Ean aE 2
ed WHouputal 2S lores and Clunncliine

mee | nto foots ’ Sito. Poell

Dranay : a Ladlona 70 fell.
Shows “lone Juelz lt .

 Minegar eb Se his

CMe lon. : Hes hae | Zo ie

we Boomms  -» dB eel im
Aol . hh JZ aie UN

Bordoa Dea... |. i ZL qa
i Fol

 

 

TEENIE

.»” Lina

 

 

 

 

 

fea LLCS
|

<3
EY
hww Bo

wih fore
Ch. 6]

Between Wars: 1783-June 1812

Hospulil Sbsres %* bondi ca...

 

 

 

 

 

— i Posks | Sous
(Malia ies Fan rea aie eve PRE AE hod
Blan ¥e la . rane waded veri willl os rey
Gln” spies ae ye AEG {oe ia aa
| 7. :
Punt... Er,
gig lon. vial be

 

Snoitia Ain Putin, otiiny Linon ar pul
oe my
Wi RA Ton l ot “ ong 0 amat- 24

 

 

 

 
  
  

 

 

 

vide, a ohect- shout measiuc » ie £7. pwede
Hn fn efiaece 3 Phe came 4 J Lhe
“ number « Ebpanic ot ed os whore ot wom
ao de mee pi we penn aru derice-
se # onside s naady gre
no tiiiments necg Gay dae one elit foot.
Amis baling 7 Shonge eg 2
AS Thad boattartes .. . . ls i Shep Hema... ar |R
\ Seales and Wp Ko | f 8 Wiuprowe paper 2 6
3 RB ellmelil mosis peat / 3
562" wun. |W A eatin “pel
Coron Aomectr. i...) 8 wba antilis, each, wpe lc #e 4
Pence Li ng eo i Dy '2 Jonnie Kew with Slatuonass, an v. ]
3 [008 ate... |3] Rehm ponts 6 sures sf omitity |
™ The. ws e | pater, Sather. Pui 7X ui ok
i
¢

mame es oS pile bv.

Z

a

BU Boxes Re 452 wd ne

 

 

147
7

Administration of Medical Support,
June 1812 to January 1815

Largely because of British impressment of
American seamen and their aid to the In-
dians, the United States had been anticipat-
ing war with Great Britain for several years
before the actual declaration on 18 June
1812, but neither the Army nor the organi-
zation of the Army’s medical support was
ready for open hostilities when they came.’

OPENING MONTHS OF THE
WAR OF 1812

The direction of the nation’s armed forces
at this crucial time remained in the some-
what inept hands of Secretary of War Wil-
liam Eustis. It was Eustis who sent Brig.
Gen. William Hull orders hours before war
was formally declared but did not inform
him that this step was imminent. It was also
Eustis who assigned Maj. Gen. Henry Dear-
born to command in the North without tell-
ing him that his command included Detroit,
leaving General Dearborn to assume that
Detroit was not his responsibility. Eustis
resigned in December 1812, however, and
was replaced by John Armstrong.

Initial preparation for war involved little
in the way of organizational change for the
Army despite the increase in size from
slightly more than 6,500 in 1812 to 19,000
in 1813. The nation’s leaders had little en-
thusiasm for centralization and staff offices;
the medical department which had been es-
tablished in anticipation of war with France

at the turn of the century had been disbanded
when the threat abated. The enrolling of
surgeons and mates to be directly attached
to hospitals had been authorized in 1808,
however, and the assignment of surgeons
and mates directly to regiments was revived
in January 1812. (See Table 7.)

Eustis continued LeBaron in his informal
position as inspector of the supplies needed
by the Army’s surgeons in their work but
supervised his work closely. With the coming
of war, however, it became necessary to
establish depots beyond the one already
planned for Albany, which Eustis was plan-
ning to turn into a major medical supply
center for troops all along the Canadian
frontier. Late in August, the Secretary of
War sent LeBaron a series of orders requir-
ing him to send at once to Pittsburgh “medi-
cine & apparatus for five Regiments, in small
chests; also to Annapolis, medicine, surgical
instruments &ca, for four hundred militia on
duty at that place.” 2 Only a few days later,
Eustis also ordered LeBaron to send “the
necessary medicine & Stores for an Hospital
Establishment at New York.” ®

Although the militia called into federal
service supplied its own surgeons, it looked
to the Regular Army for medical supplies.
LeBaron was, therefore, required to send
sufficient hospital stores and medicines from
his Albany warehouse to Niagara for the
5,000 militia there and to be prepared,
should there not be a sufficient quantity on
Ch. 7]

hand at Albany to meet this requirement, to
send more north from Philadelphia at once.
Supplying the militia, however, made antici-
pation of needs much more difficult. Al-
though militia and volunteer units played an
important role in the War of 1812, the
accurate prediction of how many such units
might come in or when they might appear
was impossible. Should unexpectedly large
numbers come in during the autumn or
spring, the “sickly seasons,” shortages could
occur very rapidly.*

Eustis directly supervised the financial
management of medical supply and ordered
LeBaron in October 1812 to prepare esti-
mates on projected expenses for 1813. He
also informed LeBaron that the Quarter-
master believed that money could be saved
by purchasing supplies where they were to
be used, thus avoiding shipping expenses.
LeBaron, however, explained that local
sources of supply, even for such easily
obtained items as vinegar and cornmeal,
were uncertain and that he could not be sure
of obtaining these items locally when they
were needed.’

Eustis also personally made decisions such
as the one involving the size of the medicine
chests to be constructed for the Army’s use.
LeBaron was ordered to have small chests
made, despite the fact that surgeons could
not seem to agree about what medicines
were absolutely necessary to such a chest.
LeBaron pointed out that when large chests
were used, he could include adequate
amounts of all the drugs which might be
required without being forced to try to
predict what each individual surgeon might
use in every possible situation. It was not
until the following spring that the discussion
was finally resolved in favor of small chests.

LeBaron himself criticized the lack of
system and organization which made “wan-
ton waste” possible and noted that the
surgeons themselves were complaining that
they were unsure as to the nature of their
responsibilities. He cited an instance when a

Medical Support Administration: June 1812-January 1815

149

militia surgeon reported for duty at a site
where three months’ allowance of hospital
supplies was stored for militia use, then
invited in his friends, “and eat, & drank them
up,” returning home before the hospital
surgeon for the area could discover what
had happened.”

WORK OF THE MEDICAL
DEPARTMENT

Nine months of the War of 1812 passed
before the offices of Physician and Surgeon
General and Apothecary General were
created in March 1813. Although demands
upon the Army’s physicians were heavy, it
was June before appointments to these posi-
tions were actually made, and the additional
regulations necessary to complete the central
organization of the Army Medical Depart-
ment and to define its functions were issued
at irregular intervals throughout the re-
mainder of the war.

It was on 3 March 1813, in an act re-
organizing the general staff of the U.S. Army,
that the Congress also created in a few
brief words the positions of Physician and
Surgeon General and Apothecary General,
both of which were to be filled by civilians.
(See Appendix I for texts of those portions
of major legislation which affected the Medi-
cal Department.) Unlike the department
designed in 1799, this new organization
involved only the Army, and rather than de-
tailing the responsibilities of both officers, it
made the President responsible for outlining
the specific duties of both.® In May 1813,
therefore, President Madison issued his
“Rules and Regulations of the Army of the
United States.”

The new regulations forbade private prac-
tice to all Army physicians and outlined the
duties of the Physician and Surgeon General,
who was made responsible for the specific
assignments of individual surgeons. The
Physician and Surgeon General was also
responsible for the appointment of stewards
150

TABLE 8—PAY AND ALLOWANCES FOR THE STAFF
OF THE MEDICAL DEPARTMENT, MAY 1813

 

 

Monthly Forage

Position Salary | Allowances | Rations
Hospital Surgeon $75 2 6
Hospital Surgeon's 40 2 2

Mate
Steward 20 0 2
Wardmaster 16 0 2
Surgeon 45 2 3
Mate 30 2 2

 

 

 

 

SOURCE: American State Papers: Military Affairs, 1:435.

Note: The Physician and Surgeon General received a straight
salary of $2,500 a year without allowances, the Apothecary
General $1,800 without allowances.

and nurses and for the management and use
of the stores, instruments, and medicines
bought for the Medical Department by the
Purchasing Department, with the Apothecary
General serving as his assistant. A scale of
pay and allowances was also established for
the department and, in addition, every hos-
pital and regimental surgeon was granted the
privilege of a private room at whatever
facility he was serving. (Table 8) Another
passage in the May 1813 regulations pre-
scribed a uniform for the Physician and
Surgeon General, the Apothecary General,
and hospital surgeons and mates. It was to
resemble that of the general staff, but was
specifically characterized by an embroidered
gold star on the high collar of the black coat,
“pocket flaps, and buttons placed across the
cuffs, four to each, and covered buttons in
all instances, of the color of the coat.” ?

The following December, further regula-
tions were issued to govern the department’s
operations. The senior surgeon assigned to
each of the nine military districts into which
Secretary of War Eustis had divided the
military organization of the country in 1812
was to be the director of the medical staff of
that district, including regimental surgeons.
The specific assignment of each physician
was to be based upon his personal ability
and training. All Army surgeons had to be
either graduates of approved medical schools

THE ARMY MEDICAL DEPARTMENT,

1775-1818

or capable of passing an examination ad-
ministered by an Army examination board.
In the spring of 1814, one such board con-
sisted of the Inspector General of the Army,
the Physician and Surgeon General of the
Medical Department, two hospital surgeons,
and three regimental surgeons.?

The areas covered by the military districts
in the spring of 1813 were as follows:

1: Massachusetts, New Hampshire

2: Rhode Island, Connecticut

3: New York to the Highlands, part of New
Jersey

Part of New Jersey, all of Pennsylvania and
Delaware

Maryland, Virginia

North Carolina, South Carolina, Georgia
Louisiana, Tennessee, Mississippi

Kentucky, Ohio, Northwest Territory

New York north of the Highlands, Vermont

SoURCE: Marguerite McKee, “Service of Supply in the War of
1812,” Quartermaster Review 6 (1927): 49-50, 50n.

FN

OO 00 JON Wn

Modifications and additions to these regu-
lations continued to appear during the
course of 1814. In March, for example, two
rations a day and forage for two horses were
added to the salary already allowed the
Physician and Surgeon General, and $15 a
month was added to the pay of regimental
surgeons and mates. The President was now
also permitted to hire as many assistant
apothecaries as he believed necessary. In
December 1814, yet another set of regula-
tions for the Medical Department was issued
and policy limiting the number of patients
admitted into general hospitals was officially
stated; unless the movements of an army
required leaving its patients behind, only the
wounded or the chronically ill should be
sent to the general hospital. The Apothecary
General and his assistants were at this time
made directly responsible to the superintend-
ent general of military supplies for the dis-
bursement of all hospital supplies bought for
the Medical Department by the Commissary
General of Purchases.!' (For a detailed
description of the duties of various members
Ch. 7]

of the department as understood at this time,
see Appendix J.)

By the end of 1814, the departmental
structure included hospital surgeons, who
were assigned responsibilities according to
their seniority, and their mates, as well as
post or garrison surgeons and regimental
surgeons and mates. The senior hospital
surgeon in an army or district served as its
medical director and was responsible for the
medical staff of that army or district. Al-
though regimental surgeons and mates seem
to have been identified with their regiments
more closely than with the Medical Depart-
ment and the reports of the Physician and
Surgeon General did not even mention them,
they were nevertheless required to submit
monthly and quarterly reports to the medical
director of the army or district in which they
were serving. These reports were consoli-
dated with those from hospital surgeons and
post surgeons by the senior surgeon in
charge and forwarded on to the Physician
and Surgeon General.!?

The precautions necessary to ensure high
standards of cleanliness and sanitation were
officially spelled out in the December 1814
directives. The wardmaster, for example, was
responsible for seeing that closestools were
cleaned at least three times a day and that
either water or charcoal was kept in them.
Beds and bedclothes were to be aired each
day and exposed to sunlight when possible.
The straw in each bed sack was to be chang-
ed at least every month. When a patient was
discharged or died, the straw from his sack
was to be burned. Each patient was to be
washed every day and his hair combed. At
least one female attendant was to be as-
signed to each hospital or infirmary to per-
form such menial tasks as the cleaning or
washing of bunks, floors, bedding, and cook-
ing utensils, for which she was to be paid no
more than $6 a month plus one ration a day.

The regulations of December 1814 also
went into detail concerning the housing of
regimental and post surgeons and mates. Al-

Medical Support Administration: June 1812-January 1815

151

though the latter were regarded as having a
lower status than their colleagues assigned
to regiments, they were, like the regimental
and hospital surgeons, assigned to single
rooms. To heat each room, regardless of
occupancy, a half a cord of wood was
allotted in the May-October period and
three times that amount during the colder
months of the year.

Regimental surgeons were made respon-
sible for the continued training of their
mates and private practice once again was
forbidden in this last set of instructions.
Should medical care be required at any time
for units unaccompanied by an Army sur-
geon, however, provision was made for the
officer in command to hire a civilian
physician and pay him according to the
patient load. Should there be more than
thirty patients involved, the civilian doctor
would be paid a salary identical with that
of the surgeon’s mate.

It was not until 11 June 1813, however,
that the position of Physician and Surgeon
General of the Medical Department was
filled with the appointment of Dr. James
Tilton. Tilton, who has been described as
“one of those American eccentrics who had
that combination of erudition and native
radicalism which has provided this country
with some of its most engaging characters,”
had become familiar with the problems of
military medicine during the Revolution and
had already expressed some distinct ideas
on the best approach to some of them.!3

At this time, however, Tilton himself was
not in the best of health. In the summer of
1814, he commented often on his “frail con-
dition,” citing his “anthrax,” which was “still
an open wound of some extent,” and the
“rheumatic swelling of my knee that is not
a little inconvenient.” * The growth on his
knee was “threatening to make a cripple of
me” in September 1814 and apparently later
proved to be malignant, his leg being am-
putated within less than a year and a half
of these references to it. There is no specific
152

 

JAMEs TILTON. (Courtesy of National Library
of Medicine.)

evidence, however, to indicate that his poor
health and the fact that he spent much of his
term of office at his home in Wilmington,
Delawzre,! interfered with his effectiveness
as heac of the Medical Department.

Serving under Physician and Surgeon
General Tilton was Apothecary General
Francis LeBaron, officially appointed to this
position on 11 June 1813, although he had
been managing the supplies since before the
outbrezk of war. Not long after he became
Apothecary General, LeBaron requested the
appoiniment of assistant apothecaries, but
fourteen months elapsed before the first two
assistar.'s were hired. By the end of 1814,
however, there were nine assistants working
under _eBaron, assigned to Philadelphia,
Norfolk, Charleston, New Orleans, Williams-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

ville, Sackett’s Harbor, New York City, New
London, and Boston.!¢

There was confusion, however, as to the
whereabouts of many of the other members
of the Medical Department. In the spring of
1814, for example, the Adjutant General
wrote Tilton to request from him a list of the
assignments given his surgeons and com-
mented that “with your list and by the help
of the records in this office, probably we
shall be able to account for and where the of-
ficers of your department are.” 7 In respond-
ing to this request, however, the head of the
Medical Department pointed out that, al-
though the list he was enclosing was accurate
concerning hospital surgeons and mates,
“The garrison surgeons and mates may be
defective, as they are a species of Surgeons
that I have had but little to do with.” 18
There was also apparently some confusion
about which surgeon was in charge in each
area. In his final report for 1814, for
example, Tilton commented of the 8th Dis-
trict that he had been told that a Dr. Turner,
who was only a regimental surgeon, had
“very improperly assumed the directing.” '®

The difficulty experienced in establishing
the locations of members of the department
can be illustrated by the wanderings of one
of its members, Dr. John R. Martin, who
was ordered in June 1813 to join Maj. Gen.
William Henry Harrison in Ohio. In Feb-
ruary 1814, however, Martin was in
Washington, D.C., but was ordered to go to
Pittsburgh, Pennsylvania. This order was
rescinded two days later and he was ordered
to remain where he was. The next month he
was ordered to Erie, New York, but two
months after this he was apparently located
in Ohio and was sent a letter which ordered
him to go to Buffalo. His presence in Buffalo,
however, was by August considered to be
“likely to interrupt the harmony which sub-
sisted” there and his assignment was changed
to Sackett’s Harbor, New York. One cannot
be sure of where Martin was actually located
while his assignments were being changed.
Ch. 7]

It seems likely, for example, that the “Dr.
Martin” who assisted another physician in
caring for wounded Americans taken captive
by the British in late August north of Wash-
ington, D.C., at a time when John R. Martin
had been ordered to upstate New York was
none other than this same John R. Martin.??
The length of time it must have taken Martin
to go from one place to another would only
have added to the confusion, and it is pos-
sible, of course, that some of these changes
of assignment never caught up with him.

The relationship of the staff of the Medi-
cal Department to the numerous militia and
volunteer units which served at various times
against the British in the War of 1812 ap-
pears never to have been specifically out-
lined. In practice, the surgeons reporting for
service with these units usually cared for
their own sick and wounded. On at least one
occasion, at the time of the British raid on
Washington in 1814, a separate hospital
was established for militia wounded.?* When
necessary, however, the hospital staff of the
Medical Department cared for these men
within the general hospital system.

Despite the criteria established in Decem-
ber 1813, the caliber of the physicians serv-
ing in the Regular U.S. Army at this time
was by no means uniform. While some
surgeons earned enviable reputations among
their colleagues, others were less fortunate.
According to the outspoken Tilton, a garri-
son surgeon’s mate at Detroit, for example,
was “not only incompetent in medical
knowledge, but so sottishly abject in his
conduct, as to be utterly unworthy of trust
or confidence.” A surgeon with the 18th
Infantry Regiment was “not only incompe-
tent, but deranged to such a degree as to
make it unsafe & improper to trust patients
in his charge.” The much-transferred Martin,
his superior noted, had been “accused of
purloining the rations of the sick.” Martin
and another surgeon were, indeed, “nothing
more than disorderly excrescenses . . . that
had better be lopped off.” 22

Medical Support Administration: June 1812-January 1815

153

In the opinion of at least one experienced
Army physician, it was difficult to retain the
surgeons who served on the regimental staff
because of the inadequate pay they received.
Costs along the Canadian frontier were par-
ticularly high, he pointed out, and regimental
surgeons and their mates tended to serve a
year because of “Curiosity alone” and then
leave.?® It should be noted, however, that
well over half of the surgeons on the regi-
mental staff in 1813 returned the next year
to serve either in the same capacity as they
had been serving in 1813 or in a different
one within the regimental framework.

By the end of 1813, the staff of the
Medical Department had become quite large
and the several documents issued since the
spring of 1813 had to some degree outlined
the way in which the department should
operate, but the policy concerning the hiring
of additional personnel appears to have re-
mained unclear. A question which arose in
the summer of 1814, however, was answered
in the December 1814 additions to the regu-
lations. Dr. Benjamin Waterhouse, hospital

 

BENJAMIN WATERHOUSE. (Courtesy of National
Library of Medicine.)
154

surgeon in Boston, commented that he was
not sure whether nurses should be allotted
rations in addition to their salaries of $6 a
month. The rules of the department as he
then understood them stated that nurses
should receive no more than $6, but nurses
of the necessary caliber could not be hired
at that rate, in his opinion. Waterhouse also
posed another question. Young men were
being actively sought to work in the depart-
ment, but he wondered whether those “of a
family, habits & connexions notorious for
opposition to the Administration, the war, &
the loaning of money to the government”
should be hired. He himself believed “that
no man should eat the bread of the govern-
ment who throws himself into the scale of
the opposition,” especially since the Army
was already “sadly encumbered by people
of this class” who were “afraid or ashamed
to wear even the cockade.” 24

During the less than two years he was in
office, Physician and Surgeon General Tilton
attempted to initiate a system of reporting
from Army surgeons around the nation. He
wished to accumulate not only data on the
numbers of hospitalized patients, their dis-
eases, and the number who died, but also
other information of value to medical science
concerning weather, climate, and the siting
of hospitals. The department was still in
such a state of confusion, however, and the
surgeons were so accustomed to working
independently that in August 1814, when
Tilton turned in his report for the depart-
ment to the Secretary of War, he was forced
to point out that his subordinates had pro-
vided him with little of the requested in-
formation. Six months later, furthermore, the
situation had changed very little."

On the basis of the reports he did receive,
however, Tilton concluded in the summer of
1814 that in general the health of the Army
was good. He believed that while improved
discipline and the resultant greater personal
and hospital cleanliness played a major roll
in the Army’s health, the effort to avoid

THE ARMY MEDICAL DEPARTMENT,

1775-1818

crowding general hospitals was also an im-
portant factor.26

In February 1815, the Physician and
Surgeon General submitted his second re-
port, which included all but the last weeks of
the hostilities of the War of 1812. There was
so little improvement in the response of the
various surgeons under him that he pointed
out to the Secretary of War that “The negli-
gent habits, which had gained footing, in the
medical department before anything like
system was attempted to be established can
hardly be reformed, without further legisla-
tive & executive aids.” Only one report had
come in from the 1st District, for example,
there was no report whatever from the 8th,
and even in the 3d District, where the senior
hospital surgeon had apparently gone to con-
siderable trouble to collect data from the
physicians under him, the reports were not
complete.27

Because of the attitude prevalent among
his subordinates at the time he became head
of the Medical Department, it is difficult to
assess Tilton’s performance as Physician and
Surgeon General fairly. He proposed meas-
ures, among them the creation of examining
boards and the submission of regular reports
from the field, which would in the hands of
his successors make it possible for the de-
partment to operate with notably greater
efficiency and effectiveness than it had ever
done before 1815; but Tilton was not in
office long enough to achieve any significant
success along these lines himself or to leave
any clear indication whether his health was
seriously limiting his ability to enforce the
orders he issued. Years of effort would have
been required to effect the necessary im-
provement in discipline, and his attempts to
exercise effective supervision and control
over the selection and assignment of Army
surgeons under the relatively rapidly chang-
ing conditions of war were also frustrated by
the inevitably slow communications of the
period.

During this period, purchasing was still,
Ch. 7]

in theory, handled on an Army-wide basis,
by the Commissary General of Purchases.
This system has since been evaluated as a
total failure, with the work of the contractors
who supplied rations receiving particularly
heavy criticism. Except where a specific
contract had been arranged, the Army’s
purchasing department was assigned the
responsibility for buying such hospital stores
as the Medical Department needed and turn-
ing them over to the Apothecary General's
department. In practice, the situation was
not so simple and the management of supply
for the newly appointed Apothecary General
was also complicated by poor roads, the
long distances which often separated garri-
sons and armies from supply centers, the
shortage of specie, and a general distrust of
paper money.28

Having been ordered on 21 June 1813 to
“establish” himself at Albany, LeBaron ar-
rived in upstate New York at the end July.
Surgeons were ordered to send him their
estimates there, where he was to requisition
his needs from the deputy commissary of
purchases and turn for transportation to the
Quartermaster General. Apparently these
three gentlemen as well as the Army con-
tractor for the area all experienced particu-
lar difficulty in meeting militia needs, and
in October 1814, the Adjutant General
ordered them to design a form which would
include the pertinent regulations and which
could be used in an effort to improve the
management of supply for these units.2?

LeBaron’s role was never an easy one; he
came under fire not only for the quality of
some of the stores he provided, which sug-
gests that he may have actually been doing
his own buying directly, but also for the way
in which medicines were packed. The Sec-
retary of War complained in the spring of
1813 that the medicine contained unneces-
sary ingredients which made “the prepara-
tions elegant” 3° and in the fall of the same
year that LeBaron’s chocolate was “a vile
cheat and highly pernicious to the sick,”

Medical Support Administration: June 1812-January 1815

155

and his port wine was “vile stuff,” “the worse
and weakest kind.” The secretary maintained
that LeBaron, who at the time complained
about high prices and a lack of funds, could
afford stores of a better quality if he ac-
quired them locally wherever possible, thus
avoiding high transportation costs.?! To fol-
low this suggestion, however, LeBaron would
have had to do his own purchasing.

The problem of the size of the medicine
chests which he distributed continued to
plague LeBaron. Some surgeons were refus-
ing to take chests with them because of the
difficulties involved in moving such large
containers when the Army was on the march,
and one physician was so impressed by their
size that he referred to them as “the most
astonishing things.” LeBaron, however,
maintained that the larger chests were used
because there had been a requirement that
no regiment have more than two chests. Since
initially neither he nor the surgeons had had
enough experience to predict precisely what
types or quantities of drugs would be needed,
he had found it necessary to supply a greater
variety and a greater quantity than might
actually be needed.32

The Secretary of War finally ordered Le-
Baron to reduce the size of the chests he
issued in the future, and the Apothecary
General began to prepare smaller ones,
weighing approximately 160 pounds, in addi-
tion to storage chests, weighing from 120
to 200 pounds, from which they could be
replenished. He was actually, however, faced
with the problem of disposing of at least
eight of the large boxes which he now could
no longer send out to the Army’s surgeons.
He hoped that the Navy would take them,
since size would not be a handicap on ship-
board, but the Navy had no need for more
chests. LeBaron then suggested sending them
to New Orleans, using water transportation
as much as possible, to serve there as a
source of supply for new posts which might
be opened in that area. The Secretary of
War pointed out that it would be wise to send
156

these containers to posts which could not be
easily supplied and where there would also
be no need to move them about.??

LeBaron tried to emphasize planning as a
method of preventing unnecessary distribu-
tion problems and urged such steps as the
establishment of a distribution center for the
South at New Orleans. Despite his efforts,
however, events he could not foresee added
to his troubles. On one occasion, while he
was away on an inspection trip, supplies
which had been accumulated at Pittsburgh
for two divisions were all sent to the single
division under General Harrison. On another
occasion, in the Niagara area, stores which
had been at Sackett’s Harbor simply dis-
appeared, “mostly lost, destroyed, or stolen.”
The troops at French Mills were in need at
this time, but Maj. Gen. James Wilkinson’s
men had already used up all the stores which
had been stockpiled at Burlington, Ver-
mont.3*

In December 1814, a third difficulty arose
when Dr. James Cutbush, Assistant Apothe-
cary General, arrived at Philadelphia to take
up his duties. LeBaron had placed all the

THE ARMY MEDICAL DEPARTMENT,

1775-1818

medicines stored there in the hands of a
civilian apothecary following the death of an
otherwise unidentified Dr. West, but the re-
tail druggist made up into medicines some of
the simple drugs which had thus fallen into
his hands and proposed that the Army pay
the retail rate to get them back.’

Many of the problems experienced by Le-
Baron and other members of the new Medi-
cal Department resulted from the fact that
the outbreak of the War of 1812 found the
Army’s system of medical support unpre-
pared to meet the suddenly escalating de-
mands placed upon it. Congress, however,
appeared relatively unimpressed by the
seriousness of the situation and assigned to
the executive the task of establishing guide-
lines for the management of a Medical De-
partment which it created only nine months
after the declaration of the war. Hastily and
casually conceived and staffed for the most
part with men unaccustomed to the demands
of military medicine, the Medical Depart-
ment was severely handicapped in its
attempts to provide adequate care for the
Army’s sick and wounded.
8

Early Campaigns in the North,
1812 to 1813

During the first campaign season of the War
of 1812, the physicians caring for the
regular soldiers of the U.S. Army were
forced to work under a decentralized, peace-
time organization. During the second season,
the effort required to meet the unpredictable
demands of war at the same time that the
Medical Department was being reestablished
made it difficult for Army surgeons to give
their patients the best care available even by
nineteenth century standards.

SEASON OF 1812

American plans for the early months of the
War of 1812 called for a three-pronged
attack on Canada by means of thrusts from
the Lake Champlain-St. Lawrence River
area, from Niagara, and from the Northwest
Territory. (Map 10) By the end of 1812,
all three moves had failed.!

For the attack against Canada from the
American side of the St. Lawrence River, six
thousand to eight thousand men were gath-
ered in the fall of 1812 at Greenbush, near
Albany, under the personal command of
Maj. Gen. Henry Dearborn. In November,
the army marched from Plattsburg, New
York, to launch an attack against Montreal.
The militia, however, stood on its right not
to fight on foreign soil. Those who did cross
into Canada managed to fire on one another
in the confusion. After the fiasco, the militia
returned home and the light artillery and

dragoons returned to Greenbush. Three regi-
ments of regulars went to Burlington, Ver-
mont, for the winter, while three more spent
the season at Plattsburg.

Maintaining the health of the troops in
this area was a problem from the outset. The
season was rainy and the ground was wet.
Although the camp at Greenbush was often
moved, diarrhea and dysentery took a con-
siderable toll. Not only intermittent fever
but also typhus and rheumatism were pre-
valent even as early as mid-September.
Despite the threat to the army posed by the
high disease rate, when Dr. James Mann,
placed in overall charge of the medical serv-
ices for the forces in upstate New York,
arrived at Greenbush the second week in
August, he found that the physician who was
to have preceded him had not arrived and
that the troops were without medical care.?

Since no preparations had been made to
care for those of the men at Greenbush who
might fall ill, upon his arrival Mann had to
go over the hospital supplies, which, for-
tunately, he found to be in good order, as
well as to care for the ill with the aid of but
one other physician, a regimental surgeon’s
mate who arrived a few days after Mann.
There were no buildings prepared to receive
the sick and Mann did not wish to erect new
tents because of the wet ground, so the sick
were left in the tents they shared with their
healthy comrades. An average of 100 men
fell ill each week at Greenbush, and by the
 

  
  

Montreal 5

WAR IN THE NORTH

  
   
   
      

 

F / 7 42k re
] Tenc ample
1812-1814 CANADA Mills 4
@ 00
= & Plattsburg
i & Battle of
WB Plattsburg
ao
7 Brownville
Q

   

O00
S Watertown

  
    

  

Toronto

Greenbush
(York) Q i

 
 
   
    
 

   
 
 

Albany
Fort Niagara NEW YORK Pittsfield
Chippewa R

MICHIGAN
TERRITORY

 
   

     

Battle of
the Thames

Xs

    
 
   

  
  

  

Detroit

 

 

  

Rs,
“Sy; IJ
” 5
Q

 
    
 

   
 
 

—_—

Qa
<r 0% Ba % Sandusky

Fort We :
wt. Meigs Fort Stephenson
Dearborn Fort

Defiance

    

   
  
 

 

  
 
 

   
   
 

m—

INDIANA
\ TERRITORY

  

OHIO

ILL. TERR.
J—

—_—
—

 

=
fe

MAP 10

‘LNAWIYVdAg TVOIAA AWYY dH 8ST

8I8T-GLLI
Ch. 8]

time the last units of the army left for the
abortive attack on Montreal, a total of 200
men had been left behind because of poor
health. Nevertheless, Mann believed that the
health of the men at Greenbush was good
when considered in the light of the fact that
most of them were new to the military life.?

Mann believed that the basic problem
which underlay all others as far as medical
support of the Army was concerned was the
lack of overall organization. He himself
worked on an outline of rules and regulations
for a hospital department when he could
find a spare moment, but he had difficulty
finding the time to complete it. He was not
sure of his authority; although he had hired
a wardmaster and steward, for example, he
had not taken on nurses or orderlies because
he was not sure that he was entitled to do
so. He also noted that conflicts with line
officers were made almost inevitable by the
ill-defined nature of the role of the hospital
surgeon.!

Among the varied duties which Mann
was required to perform in the fall of 1812
was the distribution of hospital supplies
from the Greenbush area to Niagara and
Plattsburg, New York, and Pittsfield, Mass-
achusetts; the administration of medicines
to the ill of the rifle corps who did not have
a regimental surgeon to care for them; and
the revision of diets for hospitalized pa-
tients. He decided that the convalescents in
his care did not need the full diet required
by the healthy and active soldier. Mann
suggested that the convalescent receive 12
ounces of meat and 12 ounces of bread a
day. The “half diet” should consist of 6
ounces of meat and 10 ounces of bread,
with the addition of a gill of rice or a half
pint of meal plus half a gill of molasses.
Those on a “low diet” should receive only
bread, rice, or barley with sugar, without
any meat. Although chocolate or tea with
sugar was to be permitted from time to
time, Mann opposed the use of whiskey.”

Mann regretted being so busy with his

Early Campaigns in the North: 1812-1813

159

responsibilities as hospital surgeon that he
had little time to study the diseases he en-
countered and to record his observations.
During the fall and winter of 1812-13,
however, he saw many cases of rheumatism,
pneumonia, measles, dysentery, and inter-
mittent fever. When he first arrived at
Greenbush, he also found that a few of the
men had fallen ill with what he diagnosed
as typhus before they reached the camp.
Four of the seven men who died in the
period from mid-August to the end of Sep-
tember were from among this group of
typhus patients, and two others who died
had long been afflicted with what we would
today call tuberculosis. Mann had expected
to encounter what he called spotted fever,
which had been prevalent in the East in
earlier years, but this disease never became
a problem in the Northern Army.°

On the basis of his observations during
the first fall and winter of the War of 1812,
Mann concluded that rheumatism afflicted
men older than 40 more frequently than
younger soldiers and was quick to recur
after exposure to wet, cold weather in those
who had previously suffered from it. Mann
preferred to reserve venesection for the
treatment of the acute form of rheumatism,
using calomel, opium, blistering, and the ap-
plication of warmth for chronic cases.”

Among the other conditions studied by
Mann were pneumonia and dysentery. In
some cases of pneumonia, death could oc-
cur within 24 hours of the appearance of the
first symptom, which was usually a sensa-
tion of weight upon the chest. The conva-
lescent from this form of pneumonia, Mann
noted, often had a jaundiced appearance.
The type of dysentery seen by physicians in
the North at this time “was attended in most
cases with a fever of the synochal type, ac-
celerated action of the arteries, and heat
increased considerably above the healthy
standard.” Mann favored treating it by
bleeding, preferably a single bleeding of
16 ounces followed by a “full cathartic of
 

WILLIAM BEAUMONT. (Courtesy of National
Library of Medicine.)

calomel and jalap.” “Anodynes,” or pain-
killers, might be administered after the “in-
testines were well evacuated.” Mann also
discovered that “There were cases when
calomel and opium, in small doses, at inter-
vals of 4 or 6 hours, were found beneficial.”
Emetics were generally used only when all
else had failed, but dysentery could take
on “a typhoid form” which made the ad-
ministration of wine or diluted brandy, up
to two pints of the former, as well as pur-
gatives, advisable. Milk was also recom-
mended, especially for the convalescent from
this variety of dysentery, but meat and
broths were strictly forbidden.®

Intermittent fevers apparently appeared
at Greenbush only in men hailing from
south of the Hudson River who had had the
disease before. These men were treated
with emetics when the “cold stage” was
about to appear and then, during periods

ARMY MEDICAL DEPARTMENT,

1775-18138

when there was no fever, with cathartics,
bark, and wine in addition to the emetics.
A disease which was more common than
intermittent fever was measles, which, at one
time or another during the winter, afflicted
as many as one-third of the entire army.’

Among the physicians who eventually
served under Mann was Dr. William Beau-
mont, a surgeon’s mate, who later was to
gain fame through his studies concerning
digestion. At this time, Beaumont was
particularly concerned with the respiratory
diseases he was encountering with great fre-
quency. He commented that the men were
making “the very woods ring with coughings
& groaning.” Pleurisy was a common af-
fliction among his patients and was handled,
in its earliest stages, by bleeding followed,
as the symptoms subsided, by the adminis-
tration of opium, digitalis, and “Glyc. Snn
Tart. Atn,” a combination Beaumont found
to be “very efficatious [sic] in relieving the
Cough.” For patients who could not other-
wise be relieved, Beaumont favored the
raising of blisters."®

Mann believed that attention to certain
precautions could lower the incidence of
disease within the Army. Soldiers should,
for example, wear woolen shirts. “Spirits”
should be eliminated from the rations of the
healthy as well as from those of the sick,
since “Immoderate potations of spirits by
weakening the sensorial powers, and induc-
ing general debility” were a “predisponent
cause of disease.” The presence of alcohol
in hospitals would constitute a threat to the
health of the soldier who was “habitually
intemperate,” who would always be “in-
dustrious to procure the means of indulging
his appetite.” Mann observed also that some
of the men were convinced that “ardent
spirits” were good for bowel complaints and
were, apparently, dosing themselves to the
point of inebriation.!!

No matter how successful Army surgeons
might be with their patients, however, there
would always be those who, for political
Ch. 8]

reasons of their own, in Mann’s opinion,
would be willing to exaggerate the Army’s
rate of death and disease “with design to
render government and its officers odious.”
Furthermore, Mann maintained that this
rate would always be higher than the public
might expect it to be because young and
healthy men did not join the Army.!?

Early in February 1813, Mann made an
inspection tour of the hospitals caring for
General Dearborn’s men at Plattsburg and
Burlington. He was favorably impressed by
the way in which Dr. Joseph Lovell, later
to become Surgeon General of the United
States Army, was managing the hospital at
Burlington, although the number of deaths
there from November to February ap-
proached 200. The death rate at Plattsburg,
where the surgeon’s mate who was in charge
of that unit kept the wards clean and in
good condition and supplies were more than
adequate, was comparable to that at Bur-
lington.13

When Mann returned to Greenbush, how-
ever, although the progress being made on
a new building was encouraging, he dis-
covered that the surgeon he had left in
charge had been seriously neglecting his pa-
tients and that a pneumonia epidemic was
growing. Mann was so angered by what he
found that he considered placing formal
charges against his subordinate but finally
decided against taking so drastic a step. De-
spite the situation which had developed in
his absence at Greenbush, only eighty-nine
patients had died there from 1 August 1812
to February 1813, with the highest rates oc-
curring in December. Mann attributed the
improvement which followed in January to
a change from using “stimulants . . . . em-
ployed as medicine” to ‘evacuating and
antiphlogistic” remedies.!*

The American forces in the area between
Lakes Ontario and Erie, slightly less than
half of whom were militia, numbered about
6,500. They were divided among Lewiston,
Buffalo, and Fort Niagara. It is not sur-

Early Campaigns in the North: 1812-1813

161

 

JosePH LoVELL. (Courtesy of National Library
of Medicine.)

prising that the campaign here was also a
failure; the militia exercised its right not to
fight on Canadian soil whenever it wished,
the commander of the militia was totally
lacking in military experience, the com-
mander of the regulars was unreliable, and
the two commanders were apparently in-
capable of cooperation.

The health of the men on the Niagara
frontier appears to have been no better than
that of their fellows in northeastern New
York State. A letter written in early No-
vember 1812 from Buffalo reported that
three or four of the Regular Army there
were dying each day and that more than
100 of those wounded in an attack on
British-held Queenston on 13 October later
died. The high death rate there was blamed
on a lack of “proper surgeons.” The most
common diseases afflicting the men at Buffa-
lo were measles and dysentery, the latter
being blamed on the fact that the men were
eating fresh meat. At Lewiston, some units
reported one-third to one-half of their men
sick in November, and it was noted that
the hospital tent of one regular infantry
162

regiment held the bodies of five men who
had been dead more than 24 hours but had
not been buried because of a shortage of
coffins.?

The 1,300 regulars at Fort Niagara were
cared for by three physicians. One was
attached to the fort's regular garrison and
two were from regiments newly stationed
there. The situation of the surgeon of the
14th Infantry Regiment may well have been
indicative of that faced by others near
Niagara. In early October, he was without
medicines, hospital stores, or surgical instru-
ments. There were, unfortunately, not only
sick but also wounded needing care at
Niagara because the fort was bombarded at
times by the British guns across the Niagara
River.1¢

Brig. Gen. William Hull was in command
of operations in the Detroit and western
Great Lakes area in the first few months
of the War of 1812. He arrived at Dayton,
Ohio, early in the spring of 1812 and
marched northward from there, reaching the
Rapids of the Maumee River by the end
of June. Here, since his horses were ex-
hausted, he hired a schooner, the Cuyahoga,
and a small boat to carry his sick and
wounded and a major portion of his bag-
gage, including his medical supplies and a
trunk full of confidential military records,
the rest of the way to Detroit.!”

The British, however, controlled Lake
Erie, and to reach Detroit the Cuyahoga
had to pass under their guns at Fort Malden.
Since General Hull had not been officially
informed that war had been declared, he
was unaware of the magnitude of the risk
he was taking. The enemy, having learned
of the declaration of war, captured the
Cuyahoga on 2 July, but the small boat,
carrying some of the sick, seems to have
escaped to arrive safely at Detroit.!8

There is some confusion as to what hap-
pened to the small boat and its occupants.
A few patients and the surgeon’s mate from
the Ohio volunteers who was sent along

THE ARMY MEDICAL DEPARTMENT,

1775-1818

with them apparently were in this craft.
Although the diary of a physician captured
by the British at this time has been attrib-
uted to this mate, Dr. James Reynolds, by
its editor, others have disagreed with him.
The preponderance of the evidence seems
to indicate that the physician in the small
boat and, presumably, the patients with
him, reached Detroit safely on 3 July 1812
and that Reynolds was killed just before
General Hull's surrender of Detroit in
August by a nearly spent ball which tore
off one leg and mangled the other.!®

After their hospital supplies were cap-
tured, the providing of medical support for
General Hull and the bulk of his army after
their arrival at Detroit by land on 5 July
posed a problem. New supplies were to have
come in from Fort Fayette, located near
Pittsburgh, but Fort Fayette itself was short
on these items also. Further difficulties, ac-
cording to General Hull, were caused by the
fact that the hospital surgeon originally as-
signed to the units at Detroit, Dr. Josiah
Foster, died before he had progressed far
in the organization of medical services there.
Foster’s place was taken by Dr. Abraham
Edwards, a former surgeon’s mate who had
also had experience as a line officer.’

The British deliberately played upon Gen-
eral Hull's fears. Rumors were circulated
about huge numbers of Indians who were
presumably thirsting for American blood.
Canadian militiamen were clothed in the
red uniforms of British regulars and paraded
where the Americans could see them. On
16 August 1812, in what one historian has
termed “one of the most disgraceful epi-
sodes in the military History of the United
States,” 2! General Hull surrendered not only
Fort Detroit but other forts in the area as
well.

Among those included in General Hull's
surrender was a detachment of fifty-four
men with their families at Fort Dearborn,
where Chicago now stands. The physician
caring for the population of this fort was
Ch. 8]

Dr. Isaac Van Voorhis of the 54th Infantry
Regiment. At the time of the surrender,
General Hull ordered Fort Dearborn evacu-
ated and, despite warnings from friendly
Indians that they would be ambushed, the
occupants obeyed. An estimated 1,500 In-
dians set upon the small group, which in-
cluded 9 women and 18 children, after it
left the shelter of the fort and killed 30
soldiers, 10 male civilians, 2 women, and
12 children. Among the dead was regimental
surgeon Van Voorhis.??

Not long after General Hull's surrender
at Detroit, Brig. Gen. William Henry Har-
rison was appointed commander of all
forces, regular and militia, a total of ap-
proximately six thousand men, in the North-
west. Several expeditions were sent out
against the Indians during the fall, and by
December, General Harrison’s men held a
line across northwest Ohio from Fort De-
fiance to Sandusky.

By November, however, typhus had ap-
peared among General Harrison’s men, the
weather was cold and wet, and proper
shoes and clothing were lacking. Three or
four men were dying each day. On Christ-
mas, one of General Harrison’s officers re-
ported that, of the approximately six hun-
dred men in his unit, recently returned from
an expedition against the Miami Indians,
more than three hundred were suffering such
severe frostbite that they were unfit for
duty.2?

Near the ruins of old Fort Defiance in
the fall of 1812, where militia units and de-
tachments from two infantry regiments were
stationed under Brig. Gen. James Win-
chester, the burden borne by the Army’s
physicians was great. Hospital stores were
being stolen before they could be delivered
at the camp, and typhus was raging among
the men. By winter, although the new fort,
including its hospital, had been completed,
supplies were exhausted and the suffering
from cold and hunger was increasing. One
of Winchester’s men noted on Christmas

Early Campaigns in the North: 1812-1813

163

Eve that “Our sufferings in this place have
been greater than if we had been in severe
battle. More than one hundred lives have
been lost, owing to the bad accommodations.
The sufferings of about three hundred sick
at a time, who are exposed to the cold
ground and deprived of every nourishment,
are sufficient proof of our wretched condi-
tion.” 2¢ Wrote another soldier, “We now
saw nothing but hunger, and cold, and
nakedness, staring us in the face.” 2°

Having been ordered by General Harrison
to move from their new fort to the Falls
of the Maumee River and to build huts
there for the winter, General Winchester and
1,200 men set out, arriving at the rapids on
10 January. Shortly thereafter, upon learn-
ing that the Americans at a small settlement
called Frenchtown (now Monroe, Michi-
gan), thirty-five miles away and only eight-
een miles from British-held Fort Malden,
were being threatened by the enemy, Gen-
eral Winchester sent an advance party of his
men to help them.?¢

After an indecisive engagement on 18
January when more than fifty Americans
were wounded and twelve killed, these men
set up camp at the village. The officers took
over some private homes and the hospital
was set up in a tavern at some distance from
the main camp. On 21 January, however,
after General Winchester and the main body
of his force had joined the men already at
Frenchtown, the enemy attacked and over-
whelmed the Americans, killing 397,
wounding 27, and capturing more than 500,
including General Winchester. Among the
dead were the senior surgeon for the entire
force and the surgeon of the 17th U.S.
Infantry Regiment. Another physician had
taken up the weapon of one of his patients
while the struggle was still taking place and
set out to join the fighting; he was never
seen alive again. A volunteer surgeon and
his mate were captured when they elected to
remain with about sixty to sixty-five
wounded men at the hospital.?”
164

On accepting the surrender of the Ameri-
cans who were still fighting, the British
promised to assign a guard for the wounded
to keep them from being killed by the
Indians before they could be moved to
Malden. The promise was ignored, however.
No guard was posted, and so, after enjoying
the liquor they found stored in the tavern-
hospital, the Indians tore the blankets away
from the wounded and then set fire to the
buildings. Those who tried to escape were
shot and tomahawked.?®

General Harrison attempted to aid Gen-
eral Winchester, but his relief party was
unable to reach the scene of the battle in
time.?® General Harrison then fell back on
the Maumee River and, abandoning any
further thoughts of a winter offensive,
passed the rest of the winter constructing
the fort to be known as Fort Meigs.

SEASON OF 1813

Although there was military activity both in
the North and the South during the cam-
paign season of 1813, the United States
forces involved in the South were for the
most part either those of the Navy or of the
Tennessee unis of Andrew Jackson which
he led against the Creek Indians of the
Mississippi Territory. General Wilkinson’s
expedition of Army regulars into West
Florida which culminated in the occupation
of Mobile met with no opposition. In the
Northwest, the campaign season of 1813
was so successful that by the onset of winter
and after young U.S. Navy Commander
Oliver Hazard Perry’s victory over a Brit-
ish fleet on Lake Erie, the entire area was
under American control. General Harrison
was thus able to move 700 of his regulars
from the Northwest to Buffalo and Sackett’s
Harbor. Although the general himself re-
signed from the Army at this time, these
men took part in the campaign in western
New York State.

In the Northwest in 1813, there do not

THE ARMY MEDICAL DEPARTMENT,

1775-1818

appear to have been any general hospitals,
at least not of the size and caliber of those
in northern and western New York State.
There were garrison facilities at some of the
posts,*® but presumably most of the ill and
wounded of General Harrison’s army were
the responsibility of regimental surgeons and
mates or even of militia physicians.

During the spring and early summer of
1813, General Harrison’s army was in un-
usually poor health and his hospital stores
and medicines were being consumed not
only by the sick but also by the wasteful
habits of militia surgeons and mates at the
various small posts scattered throughout
the Northwest. Hospital supplies of liquor
were apparently a source of particular con-
cern to General Harrison, who noted that a
“dry Barrell” should be “put over that which
contains” hospital liquor because ‘“Experi-
ence has long since convinced all those in
the Western country who are desirous of
having their Liquors secured from plunder
and adulteration that it is the only way of
affecting it.” 31

In May 1813, the enemy attempted to
take Fort Meigs before the reinforcement
expected by the troops there could arrive.
Although the siege was abandoned after
nine days, the defenders suffered 81 killed
and 189 wounded at a time when the
medical support available for them was “ex-
tremely deficient in almost every respect.”
There was “no head to the Hospital De-
partment,” and the surgeons were young
and inexperienced and, for the most part,
from the militia. One officer noted that the
militia was content to look for its physicians
“wherever a person could be found with a
lancet in his pocket, or who had by some
means or other obtained the title of doctor.”
Although there had been a “man of skills
and talents” in charge of the medical serv-
ices at this fort before the siege began, this
otherwise unidentified gentleman was no
longer in the Army by May of 1813, having
left both the fort and the Army, it would
Ch. 8]

seem, in disgrace, considered to be “alike
destitute of honor and reputation.” 32

There was no place to put the wounded
at Fort Meigs while it was under siege; they
lay in trenches “on rails barely sufficient to
keep them up out of the water, which in
many places from the bleeding of the
wounded, had the appearance of puddles
of blood.” There were even times when
there was nothing available with which to
cover these unhappy creatures, since the
same supply shortages experienced by other
camps also afflicted Fort Meigs. The force
there was so shorthanded that men could
not even be spared to give adequate care to
the wounded,?? several of whom died “of a
lock-jaw,” brought on, General Harrison
believed, by “their great and unavoidable
exposure to the cold.” 3

Once the siege was over, blockhouses
were cleared of guns and stores and turned
into temporary hospitals, but the men were
still “but badly provided with the little
necessaries and comforts which belong and
afford so much relief, to the brave soldier
who has recently lost a leg or an arm, or
had his side pierced with a bayonet.” 3%
General Harrison took it upon himself to
forward an urgent order worked up by a hos-
pital mate for medicines and stores in their
behalf. (See Chapter 1.)

General Harrison's operations in the
summer and early fall of 1813 in the Lake
Erie area were successful and culminated
in October in the defeat of the British and
their Indian allies in Canada at the Battle
of the Thames River and the death of the
Indian leader Tecumseh. However, ap-
parently little had been done in advance to
prepare for the care of the sick and wounded.
One of the men with this expedition de-
scribed coming down with “the Ague” on
board a boat because of the wet, cold
weather. He had, apparently, no alternative
but to continue the march once on land.
The only help available to the sick was
that which their fellows could provide by

Early Campaigns in the North: 1812-1813

165

carrying their weapons and packs for them
and, when crossing small streams, by car-
rying the sick themselves on their backs.3®

After the final battle in October, General
Harrison reported that five of his men
had been killed and twenty-two wounded in
the engagement and that five of the
wounded died shortly thereafter. Although
there does not seem to be any record of
where these men were initially cared for,
after Detroit was recaptured a hospital was
opened under Dr. Cornelius Cunningham, a
garrison surgeon’s mate, in the house
formerly occupied by Governor William
Hull. For a brief time before moving on
to New York State, General Harrison and
his men returned to Detroit, and in Novem-
ber of 1813, four hundred of the regulars
who had been with him in Canada were
left behind in the Detroit facility. By this
time, the sick rate was again soaring and
the men were both tired and hungry. Some
of the illness was blamed upon the large
quantities of bad bread they had reportedly
eaten. A month later, however, the situation
had not improved. “The troops . . . . still
Continues to be very much sick and many
have Died since we came to this place.” 37

In the Northeast, troops under Maj. Gen.
Henry Dearborn left Sackett’s Harbor in
April 1813 to take Toronto, then called
York, and Fort George. (See Map 10.) They
then held off an enemy attack on Sackett’s
Harbor itself, but in December 1813, the
British launched a successful attack, retak-
ing Fort George and capturing Fort Niagara
as well. A series of enemy raids which in-
cluded the burning of Buffalo and Black
Rock brought the hostilities of that cam-
paign year along the Niagara to a close.

Farther east, a two-pronged American
move against Montreal in the autumn of
1813 was a complete failure. After replac-
ing the ailing General Dearborn at Sackett’s
Harbor, General Wilkinson moved east
along the St. Lawrence River, intending to
join Maj. Gen. Wade Hampton's forces
166

THE ARMY MEDICAL DEPARTMENT,

1775-1818

 

FORT NIAGARA. (Courtesy of Library of Congress.)

moving north from the Lake Champlain
area. Both generals, however, retreated after
separate defeats by the enemy. General
Hampton returned to Plattsburg and Gen-
eral Wilkinson fell back on French Mills.
General Wilkinson was accused at this time
of excessive drinking and of attempting to
blame his condition on illness.?$

In New England and the states south of
New York in this period, where there was
little if any military action involving the
Regular Army, there were at least one or
two garrison or regimental physicians in
each military district, caring for the men of
small Army units scattered among small
posts. In the Ist District, which included
Massachusetts and New Hampshire, for ex-
ample, there were eighty-seven patients at
such posts as Forts Independence, Constitu-
tion, Sullivan, Preble, Seammel, and Sum-
ner.?? (See Chapter 7.)

Although hostilities in the North and

Northwest involved both the 8th and 9th
Military Districts, the greatest amount of
action during the entire period was con-
centrated in the 9th District, or upstate New
York and Vermont. Hospitals here were
relatively numerous and during the cam-
paigns of the summer, in response to de-
mand, could be quickly set up in barns or
tents. Finding attendants for these facili-
ties, however, was difficult and they were
initially selected from the line. Such men
often turned out to be those “of incorrect
habits, and bad dispositions” and eventually
it was realized that it was better to choose
attendants from among convalescents, some
of whom could always be found who had
“happy dispositions, who were kind to the
sick.” 40

When it was necessary to move the sick
and wounded, a number of forms of trans-
portation could be used to negotiate the
notoriously poor roads of the area. Some
Ch. 8]

patients were moved in litters made of
blankets hung between poles, others in
wagons or sleighs, according to the weather,
while still others avoided the roads alto-
gether when they were moved in boats. The
concept of the ambulance also appeared dur-
ing this period; Mann referred to the “fly-
ing machines, called volantes” developed in
France during the Napoleonic Wars, *! and
Winfield Scott, in that section of his memoirs
which concerned the War of 1812 but which
was written many years later, actually used
the term ambulance. *?

The forty-ward general hospital at Bur-
lington, Vermont, with its staff of eight
hospital surgeons and mates, had as fine a
reputation as any facility in the 9th District.
Its site, sixty to seventy feet above the level
of the lake and on sandy, well-drained soil,
was healthy. Rules requiring high standards
of sanitation were firmly established. Floors
and walls were kept scrupulously clean with
soap and limewater, and all bunks were re-
moved and thoroughly washed when they
fell vacant. The straw in each bed sack was
removed every two weeks and burned. When
the weather permitted, windows were kept
open all day; when it was cold, they were
opened frequently for short periods of time.
Closestools, bedpans, and ‘“urinaries” were
removed as soon as used. Although there
could be as many as seven hundred to eight
hundred patients at Burlington at any one
time, infectious diseases did not pose a major
problem.*® The responsibility for the good
record of the Burlington facility in the first
two years of the War of 1812 was shared by
two surgeons, Dr. Joseph Lovell, who
opened the unit in 1812, and Dr. Walter
W. Wheaton, who succeeded Lovell some
time in 1813.44

Another general hospital was in operation
late in 1813 at Malone, New York, about
thirty-one miles from Sackett’s Harbor and
near the northern border of the state, where
General Wilkinson had set up his head-
quarters. An academy, an arsenal, and two

Early Campaigns in the North: 1812-1813

167

private homes which seem to have been
located near the borders of a millstream
“surrounded by a fine country of land” were
taken over for this purpose. Within ten days,
these accommodations, with a total capacity
of 250 men, were prepared to house the sick
comfortably, each man in his own bed, un-
der the supervision of hospital surgeon
Mann, who arrived in December.*3

There was at least one general hospital in
the vicinity of Sackett’s Harbor throughout
most of 1813. At Sackett’s Harbor itself
there was a facility which in 1812 had been
occupied by the militia’s patients and which
was, by the spring of 1813, when Mann first
saw it, “in filthy condition.” Dr, William
Beaumont arrived with his regiment at Sack-
ett’s Harbor in March 1813 and joined Mann
in reporting the prevalence of respiratory
diseases, diarrhea, and intermittent fevers,
among the ill there.*® Beaumont described a
type of pneumonia characterized by ‘“uni-
versal pain in the bones & musseles [sic],
cold chills, nausea & pain in the head and
breast,—sometimes accompanied with acute
local pain in the side, with cough & other
evident Pneumonia symptoms” which ap-
peared among his patients.”

General Dearborn, however, believing it
impossible to care for the sick within the line
of defense at Sackett’s Harbor, ordered a
temporary hospital established at Water-
town, New York, twelve miles from Sackett’s
Harbor. Within ten days, Mann had pre-
pared accommodations for 100 there and
moved the sick into them. Among those so
moved were twenty men whose feet had
been badly frozen in the course of a march
from Plattsburg under Brig. Gen. Zebulon
Pike. On 23 April 1813, however, Mann
was ordered to leave Watertown and to re-
turn to Sackett’s Harbor to be ready to
accompany the 1,600-man expedition pre-
paring the move against Toronto. A surg-
eon’s mate was left behind at Watertown to
care for the patients there.*8

It was fortunate that the patients had been
168

 
    
    
   
  
   
   
 
   

\| Fort Niagara

| i
Queenston, Lewiston

CANADA
NEW YORK

Lundy's Lane

Fort Schlosser

Williamsville
[eo]

| Black Rock
Oo

 

     
 
 
   

NIAGARA FRONTIER
1812-1814

Fort Erie
x

Buffalo
oo

 

MILES

THE ARMY MEDICAL DEPARTMENT,

 

 

MAP 11

moved away from Sackett’s Harbor by April
because in May, the British raided the town,
killing twenty-two Americans and wounding
eighty-four, before being repulsed. By late
June 1813, however, when a hospital surgeon
was ordered to report there, a general hos-
pital had once again been opened at Sackett’s
Harbor. A total of three surgeons and five
mates seem to have cared for the sick and
wounded here during the summer of 1813.
By early September, there were 62 in the
general hospital here as well as 501 in regi-
mental ones, and conditions remained poor.
It was reported that there was little good
water available and that the food, particular-
ly the bread, was bad. Great difficulty was
being experienced in maintaining standards
of camp sanitation because so many of the
soldiers were inexperienced, and diarrhea,
dysentery, and jaundice afflicted half of
those who were acutely ill. The atmosphere
was not considered to be healthy, and it was

 
 

1775-1818

urged that camp be moved to a drier site
for winter quarters before autumnal diseases
made their appearance in full force.*®

Further confusion exists concerning the na-
ture of the facilities in the Fort Niagara-Fort
George area. (Map 11) Mann described
a tent hospital located two miles east of Fort
Niagara where the wounded from the attack
on Toronto were cared for beginning on 8
May 1813 and also noted that about two
hundred wounded were moved from Fort
Niagara to Lewiston in mid-June 1813. It
is not clear whether it was from the tent
hospital or from a regimental facility that
those two hundred came. Despite the fact
that it was believed that the wet nature of
the area was bringing on fevers and diarrhea,
some type of hospital seems to have re-
mained here throughout the summer and
into the fall, when it was reported that two-
thirds of the sixty-five men the British killed
and fourteen of those they wounded in the
taking of that fort were hospital patients.>
Whether the hospital referred to in these
later documents was still a general hospital
rather than a regimental facility is not
apparent.

There was also a general hospital at Fort
George, which was taken from the British in
late May 1813 and held for several months.
Although the alternating cold and heat,
dryness and dampness here were blamed
for the high incidence of typhus, intermittent
fever, diarrhea, and dysentery among mili-
tary and civilian populations alike, the water
came in for its share of blame, since it was
said to have “a purgative quality.” A con-
tributing factor in the high disease rate, in
Mann’s opinion, however, “was the effluvia
from the sinks [latrines],” which filled the
air with a heavy stench even when the
“sinks” were covered with earth every day.®!

In June, some of the patients at Fort
George were also moved to the higher,
healthier facility at Lewiston. By August.
however, more than one-third of the men
still there were sick and, with half the medi-
Ch. 8]

cal staff too ill to work, only three surgeons
and four mates were available to care for six
hundred to seven hundred patients. Hospital
stores were running short by September
when Mann decided to move the general
hospital from Fort George to a site near
Buffalo and to send all 100 invalids ready
for discharge with a surgeon’s mate from
Fort George to Greenbush.??

It was in May 1813 that a unit Mann
described as a flying hospital was opened at
Lewiston in two barns and a number of
hospital tents which were located about
seventy feet above water level. Initially the
staff there appears to have consisted of
Mann and four hospital mates, who were
expected to care for as many as six hundred
to seven hundred patients or more, among
them the wounded from the garrison hospital
at Newark, near Fort George, who were
moved to Lewiston in June. Later, however,
two of the mates were ordered to Fort
George, leaving Lewiston severely under-
staffed. Mann was able to obtain a sufficient
number of bunks and bed sacks for this unit
to assign one to each patient and located a
good supply of milk for his patients.

By the end of September 1813, the
weather along the Niagara had become “very
pleasant, and the troops generally more
healthy.” The convalescents at Lewiston
were put on light duty and they did so well
that only three experienced significant re-
lapses. When his army left the area, General
Wilkinson ordered that those not strong
enough for the march be sent to Lewiston
and that Mann locate winter quarters for
them which would be secure from the enemy.
Since, with the arrival of colder weather,
the sick in the tents became uncomfortable
and some developed pneumonia, Mann con-
cluded that, although the Lewiston unit had
earned an excellent reputation, it should
now be abandoned. There does, however,
seem to have been a hospital operating at
Lewiston again in the summer of 1814.54

Although typhus and diarrhea had been

Early Campaigns in the North: 1812-1813

169

a problem in Lewiston in 1813, Mann ob-
served that wounds seemed to heal more
quickly there than at other hospitals in the
area, a fact he attributed in part to the
healthy site. Of the 950 to 1,000 men cared
for there, 59 died, with half of these deaths
occurring within a three-week period in one
sixty-man ward. Mann concluded that this
tragedy had been caused by “an imprudent
and injudicious administration of tartrite of
antimony.” %

When Mann broke up the Lewiston hos-
pital, he sent approximately 100 of the
strongest of his patients there to Greenbush
also, but 250 others were sent to Williams-
ville, the site he had chosen near Buffalo.
They were taken first in wagons from Lewis-
ton to Fort Schlosser, where they boarded
boats to travel to Black Rock. Before they
could disembark into the wagons which took
them the final forty miles to Williamsville,
however, a sudden rainstorm and wind arose
and some of the hospital stores and baggage
were lost. Six “of the most enfeebled” pa-
tients died on the way.?¢

The hospital at Williamsville was located
in an extensive barracks which had been
renovated for use as a hospital. Since some
of the men brought to this facility lacked
adequate clothing, it was doubly fortunate
that it was possible here to keep the rooms
warm. Only six men were assigned to each
ward, the rooms were easy to keep clean,
and the patients tended to recover their
health quickly. Having settled his patients
in Williamsville’s wholesome accommoda-
tions, Mann set out to join General Wilkin-
son at his winter camp at Malone, leaving
surgeon’s mate Joshua Whitridge, a physi-
cian whose ‘“‘services . . . cannot be too high-
ly appreciated,” in charge. It seems probable
that this facility, too, was closed at some
time in the winter of 1813-14 or the spring
of 1814.57

The regimental surgeons and mates of the
units in the North also established their own
hospitals or infirmaries. Beaumont described
170

one aspect of thé work of a regimental
surgeon in his account of the attack upon
Toronto in the spring of 1813, when the
explosion of an ammunition dump caused
American casualties in excess of 300, 109 of
whom came from his regiment, including 65
deaths. “Wading in blood,” he personally
operated on fifty patients in a two-day pe-
riod. “Their wounds were of the worst kind,
compd fractures of legs, thighs, & arms and
fractures of Sculls.” “I cut and slashed for
48 hours, without food or sleep-—My God!
who can think of the shocking scene, where
his fellow creatures lye mashed & mangled
in evry part with a leg—an Arm—a head, or
a body ground in pieces.” Although Beau-
mont performed his operations at Toronto,
some surgeons seem to have worked on
board ships of the American Great Lakes
squadron.®®

The patients at Toronto were placed on a
boat when it was time to evacuate them, but
for several days bad weather kept the vessel
in harbor. The men were not removed, how-
ever, and they spent a total of eight days on
board, including the single day required for
the voyage itself. They were so crowded
that the surgeons could not effectively care
for them. Although his wound was slight,
one man died, apparently of suffocation in
the close quarters. Diarrhea and dysentery
also began to make inroads among his pa-
tients, but Beaumont commented that they
survived in better condition than he would
have expected under the circumstances.
After their evacuation from Toronto, these
casualties were hospitalized first at Newark
and late in June were moved to Lewiston.5®

After the unsuccessful attempt on Mont-
real in the fall of 1813, General Hampton
was criticized for his handling of his wound-
ed, who were reportedly “very much neglect-
ed, as far as regards comfortable quarters and
transportation and . . . were strewed along
the roads through which we marched, with-
out care or attendance.” General Wilkinson’s
wounded, however, received the benefit of

THE ARMY MEDICAL DEPARTMENT,

1775-1818

organized care during the winter of 1813-14
after they arrived at winter camp. A regi-
mental hospital was established at French
Mills, in northern New York, sixteen miles
from General Wilkinson’s headquarters at
Malone. Nevertheless, the patients here had
to endure shortages of hospital stores and
medicines and a poor diet, as well as the
rigors of the weather, since they were for a
short time sheltered in tents, the two houses
taken over for their use being too small to
shelter all the sick and wounded. The short-
age of bedding required that some patients
lie upon straw on the floor. The available
blankets were of an inferior quality, and by
early December, shirts for the patients had
not yet been received. The port wine was
reportedly not pure, the chocolate was so
poor as to be inedible,®® and the flour was
“so sour and damaged, as to prove un-
healthy.” The bread his men ate, according
to General Wilkinson, contained lime, soap,
“and other extraneous and even feculent
ingredients.” The water used in making the
bread seems to have been at the root of the
problem, since it was “impregnated with,
and contains a diffusion of excrementitious
matter.” 8! Sick and death rates were high
in one instance; 75 men of a 160-man unit
were ill, 39 with diarrhea and dysentery, 18
with pneumonia, 6 with typhus, and 12 with
“paralysis of all the extremities.” 2

From June 1812, when war was declared,
to June 1813, when Tilton was appointed
Physician and Surgeon General of the Medi-
cal Department, the medical support of the
Army continued to be, for all practical pur-
poses, entirely in the hands of individual
surgeons. The creation of the office of the
Physician and Surgeon General, however,
put Tilton in a position to assign and re-
assign surgeons, surgeon’s mates, and hos-
pital attendants on the basis of the overall
need of the service and with due considera-
tion for the skills and experience of the
personnel of the Medical Department as a
group. In the Northwest, slow communica-
Ch. 8]

tion and transportation made it impossible
for any significant effects of the new organi-
zation to be felt in the period of scarcely a
year remaining after Tilton’s appointment
before the end of the campaign season of
1813-14. In the Northeast, however, the
benefits of centralization could be seen even

Early Campaigns in the North: 1812-1813

171

in this short period of time in the sending of
Mann, who had personally established an
efficient hospital out of the chaos he found
at Greenbush, to help his less experienced
colleagues with the management of other
hospitals caring for war casualties in upstate
New York and New England.
9

Defeat and Final Victory, 1814 to 1815

Enemy attacks on the Baltimore-Washington
area in the summer of 1814-15 made it
obvious that the British posed a threat not
only to the northern tier of states but also
to the borders of the entire nation. Although
by this time the care given the soldiers
fighting in the North was beginning to show
the benefits of the efforts and experience
of the Medical Department’s surgeons as-
signed to that area, the facilities available
to the regulars defending Washington and
New Orleans were in some degree over-
whelmed by the sudden need to care for
militia and volunteer casualties as well.

CAMPAIGN IN THE NORTH

Although the campaign season of 1814 in
the Northeast began with the failure of a
northward move by Maj. Gen. James Wil-
kinson from the Lake Champlain area, oper-
ations to the west, along the Niagara River,
reflected great credit upon the American
forces, in large measure because of the
training given to many of the men by Brig.
Gen. Winfield Scott and the leadership of
General Scott and Maj. Gen. Jacob Brown.
Both the Americans and the British suffered
heavy losses in these engagements; the
Americans, for example, lost 227 wounded
in the 5 July action along the Chippewa
River and more than 850 in total casualties
in the 25 July Battle of Lundy’s Lane. Un-
fortunately, both General Brown and Gen-
eral Scott were wounded in the course of
the summer, and in October, Maj. Gen.
George lzard, who led reinforcements in

from the east, ordered the Americans to
withdraw from Canadian territory.

Reinforcements for the Niagara area,
however, had been taken from among the
forces along Lake Champlain. The enemy
quickly attempted to take advantage of the
situation, but the success of American naval
forces in the Battle of Plattsburg Bay and the
resultant loss by the British land forces of
their naval support led to the withdrawal of
the British into Canada and the end of the
threat of British invasion from the north.

The Burlington hospital continued to be
one of the major Army facilities in this
area during the last months of the war. In
charge at Burlington were, first, Dr. James
Mann, the surgeon with the greatest seniority
in the 9th District and therefore presumably
its medical director, and later, Dr. Henry
Huntt, a hospital surgeon of junior status.
Under their supervision at one time or
another in the period January 1814 to April
1815 were more than 3,700 patients, fewer
than 200 of whom died.? (Table 9)

If one can generalize from Mann’s ac-
count, the most persistent problems con-
fronting the surgeons staffing this hospital
were those caused by regimental officers
and regimental physicians. Often the re-
quired records did not accompany the pa-
tients to the hospital, an omission which at
times may have been deliberate. A shortage
of blankets and bedding was aggravated by
the failure of regimental surgeons to send
the bed sacks along with the men they
sent to the general hospital. Some patients,
furthermore, were sent from regimental
Ch. 9]

TABLE 9—ADMISSIONS AND DEATHS AT THE
BURLINGTON GENERAL HOSPITAL,
JANUARY 1814-APRIL 1815

 

 

Month Admissions Deaths
Total 3,707 184
1814
January 180 7
February 671 17
March 931 29
April 630 22
May 151 17
June 59 6
July 30 1
August 33 0
September 729 31
October 105 25
November 52 11
December 13 5
1815
January 35 6
February 56 3
March 20 2
April 12 2

 

 

 

SOURCES : Mann, Sketches, p. 144; Huntt, “Burlington,”

p. 179

facilities to the general hospital only after
they had reached “a moribund state.” Mann
was particularly angered, however, when
regimental officers, often without even con-
sulting a member of the hospital staff, in-
formed one of his patients that if he did not
return to duty at once, he would be con-
sidered a deserter. Mann believed that no
officer was entitled to command a soldier
to leave the hospital without a specific order
to that effect from his commanding general.?

The strain placed upon the Burlington
hospital increased in the late summer of
1814 after patients from Plattsburg were
evacuated there in the face of the enemy
advance. An estimated 650 to 815 patients
arrived at the Vermont facility in open
boats, “a great number of them . . . unable
to walk; and some were so reduced by
disease as to be unable to tell their names.”
A sizable majority of the men had diarrhea
and dysentery * and some developed what
was diagnosed as typhus. It was noted at
this time that the suffering of such of these
men as had recently come in from the south

Defeat and Final Victory: 1814-1815

173

seemed to be greater than that of others
under these circumstances. Although the
hospital itself could hold only 300 at a
time, a barracks was taken over for the
use of these new patients, and each man
was washed and placed in a clean bed. In
early September 1814, after the Battle of
Plattsburg, seventy-nine more patients en-
tered the Burlington hospital, fifty-five of
whom were seriously wounded. Dysentery
and diarrhea were now afflicting so many
that physicians “could hardly enter a ward
without seeing half a dozen on the close-
stool,” and care was taken to keep close-
stools filled with limewater to reduce the
odor.?

The men hospitalized at Plattsburg were
not so fortunate as those at Burlington. In
December 1813, first priority had been given
here to building barracks for able-bodied
soldiers and thus the hospital facilities were
very disorganized when an epidemic similar
to that of the previous year hit the Northern
Army in the early months of 1814. As a
result, some of the sick reportedly died
from the cold. By the early summer of 1814,
the weather and “ill-judged” troop move-
ments were blamed for a “prodigious mor-
tality,” and by mid-August 1814, when
there were 100 men in the general hospital
within the Plattsburg camp, Mann was the
only physician available to care for them.
Another thirty patients were hospitalized in
the village itself at this time under Wheaton’s
management and regimental surgeons were
responsible for another fifty to ninety men.
By 1 September, surgeons at Plattsburg
were caring for more than seven hundred
men.$

Although General Izard and his men
marched for Sackett’s Harbor in late Au-
gust 1814, they left more than nine hundred
patients and convalescents from both regi-
mental and general hospitals behind at
Plattsburg. Those still hospitalized at Platts-
burg in early September were evacuated to
Burlington in the face of the British ad-
174

vance. Initially, however, because of the
lack of adequate transportation, they were
moved two and a half miles to Crab Island,
where for several days Mann, aided only by
a surgeon’s mate who was himself sick,
cared for them as they lay on the wet
ground, sheltered only by tents from the
rainy weather. Finally, however, in the care
of the surgeon’s mate, they were moved in
large open boats the remaining twenty-five
miles to Burlington.”

Although he stayed with his patients
while they were on Crab Island, Mann
continued in overall charge of both Army
and Navy wounded from the Battle of
Plattsburg and reported that while the guns
were firing, surgeons were exposed to danger
as they moved from one protected area
to another to care for the wounded. After
the battle, more than thirty major operations
were performed and these with such skill
that Mann could write that “the medical
gentlemen of our army and navy were . . .
superior to the medical gentlemen of the
British navy.” 8

The unit at Plattsburg appears to have
been reopened once the threat to the town
had passed, and by the end of the year, as
the war drew to an end, 174 were patients
still hospitalized in regimental units and 210
in general hospitals in the Lake Champlain
area, including Burlington and Plattsburg.?

In the hospital at Malone, New York,
the situation had deteriorated seriously by
February 1814. Two hundred patients had
been sent in from the camp at nearby
French Mills and every house available for
the purpose in the village was taken over
to shelter the total of 450 patients now
hospitalized in Malone. An adequate supply
of blankets, bed sacks, hospital stores, and
medicines, however, could not be located.
The sick were suffering so intensely from
the severe weather that four of them, ac-
cording to Mann, died from the cold.
“Humanity,” Mann commented, ‘shudders
at the appearance of these unfortunate men.”

THE ARMY MEDICAL DEPARTMENT,

1775-1818

It now became necessary to send the men
arriving at this hospital to other facilities,
despite their “deplorable condition.” Mann
noted that this was not the first time the
Medical Department had been overwhelmed
by circumstances.”

On 9 February 1814, all the patients
whose condition permitted it were moved
away and the hospital at Malone was
broken up. Under Mann’s supervision, more
than 450 men were sent first to Plattsburg,
a journey of about seventy miles, and then
on to Burlington. They were moved in
sleighs in small groups to avoid overtaxing
the accommodations of the sparsely settled
areas through which they had to pass.
Twenty of those in the poorest condition,
however, were left at Malone under the
care of a civilian physician and were cap-
tured by the British, while six of those who
attempted the journey died on the way.!!

Despite the crowding at Malone in the
early winter of 1814 and the reappearance
of the pneumonia experienced in the North
the previous winter, only twenty men of
the 380 admitted in the period 1 January
to 9 February 1814 died at Malone. Some
of the victims of this form of pneumonia
died in a very short time after the first
appearance of their symptoms. Among the
complications attending this illness were
“swelled feet and legs; some of these were
accompanied with mortifications; the conse-
quence of long confinement and inactivity
in the boats, wet and cold, during the pas-
sage of the army down Lake Ontario and
the river St. Lawrence.” 12

The hospital located at Sackett’s Harbor,
New York, remained there at least through
the summer of 1814 despite dissatisfaction
with the site. In the winter of 1814, the
Apothecary General complained that the
surgeons at this facility were wasteful, and
the surgeon in charge pointed out that the
2,500 soldiers there had no regimental sur-
geons or mates with them and that, although
hospital surgeons had taken over these re-
Ch. 9]

sponsibilities, more physicians were needed
at Sackett’s Harbor.!?

For the final two years of the war there
was also a general hospital at Brownville,
New York, near Sackett’s Harbor. It ap-
pears to have been closely linked with the
Sackett’s Harbor unit and from January
1814 to April 1816 was under the super-
vision of Dr. Hosea Blood. Unfortunately,
however, Blood’s report concerning deaths
among the patients under his care does not
break the figure down between Sackett’s
Harbor and Brownville. In the period 23
October 1813 to 20 January 1814 at
Sackett’s Harbor and 20 January 1814 to
April 1816 at Brownville, 325 of his pa-
tients died. Tilton seems to have believed
that the Brownville site was well chosen
since the air and water there were good,
but he urged that tents continue to be used
during the summer of 1814 and that a
large number of them be kept on hand to
meet any eventuality, since huts should be
used only in cold weather.!*

A general hospital remained at Green-
bush, New York, on the east bank of the
Hudson, opposite Albany, as late as the
earliest weeks of 1816. Little detail is
available on conditions there, but the site
was considered to be high enough to avoid
the great danger posed by the fogs rising
from the river. In the fall of 1813, a group
of patients from the hospital at Lewiston,
New York, had been evacuated to Green-
bush, and early in 1814, two hundred to
three hundred more were sent in from Buf-
falo. In his report of August 1814, however,
Tilton listed only sixty-seven patients re-
maining in the Greenbush general hospital,
but by 31 December 1814, the number of
patients at Greenbush had again increased
markedly, partly because the facility was
now caring for 161 wounded British prison-
ers as well as 160 Americans.!®

In 1814, the hospital at Williamsville,
New York, did not occupy the same quarters
it had used the previous year, and patients

Defeat and Final Victory: 1814-1815

175

were sheltered in tents while awaiting the
completion of buildings designed specifically
for use as a hospital. Progress on the con-
struction was extremely slow, however, and
General Izard wrote that “the jealousy and
quarrels between surgeons and the Quarter-
master’s department of General Brown’s
division” were to blame. In early November
1814, the new building was still “far from
ready for the reception of the sick and
wounded.” '* Some of the construction may
have been complete by 26 November, for
General Izard referred to the Williamsville
facilities at that time as an “extensive hos-
pital establishment,” but in early November,
because of the inadequacies of the facility,
General Izard, following a suggestion from
the hospital's senior surgeon, ordered that
as many as could tolerate the journey be
sent on to Greenbush. Nevertheless, almost
two thousand patients were in such poor
condition that they had to remain behind
in the tents at Williamsville.!7

There was, for a time, also a hospital set
up at Buffalo in 1814 in the tents left behind
when camp there was broken. The Ameri-
cans wounded in July’s battle at Chippewa
and some of the enemy wounded, probably
those from the Battle of Lundy’s Lane,
were sent to Buffalo. Among the British pa-
tients were some so badly burned in the
explosion of a powder magazine that their
“faces and hands were so crisped that the
skin peeled off like a baked pig.” Among a
number of American wounded who were
rowed up the Niagara River in a flat-bot-
tomed boat to Buffalo was General Scott
himself. Only those in the poorest condi-
tion were retained at Buffalo for any length
of time, however, and although some diffi-
culties were experienced in obtaining trans-
portation, all but eighty to ninety men too
seriously injured to be moved were sent
eastward, apparently within a few weeks,
to the facility at Williamsville. The Buffalo
facility was closed on 23 December 1814.18

Because of the casual nature of some
1775-18138

THE ARMY MEDICAL DEPARTMENT,

176

A Hetsiguay
5 argu
377"
Zr 2
5 wry
4 yy

i"

  

/ vag 2

7 profi
f St JPY!

| B - /
26 Gof a
g Lr 2

2 Gof;
2 gp rel” ”
¢ sil iu

I
AY
N
~
3%
NN

a
x
N

 

i? dr 4

! "Ss PF 2 z
fea 1 2 2 :
: ye Cy £4
i. z AY SAF
i 4 ltt) C180
| A ey 7¥ Th 5/47

4 7% vray

"wp W [77
20 pr 4

£/ ye a 6r%/

rr ——

Ce

     

Co i gy FE

Gey 2

gmt
Lyierf pry
IT
Zen 78
Zhe Z
Cog EE
Fy wl
i £
Zw 27 “i¥
Eg rr uy
7%

z 7

Zr

Pa

z is Zz 0]
igs
Copy

=,

Logyf Ey

i

 

    

yet

il

 

IVY IN FY SWVERnU, J)  Daesaadr] GAGA], LY) GaILLAWY], IESlidinadary

      

. iY
x

rN TN NNN a ™ « 30
2 2 Nr ANS a Rwy ey
SMA SNS aw ae YE ;
ME TEES TT,
rN ND

ve =e A SN Se

2 TNS?
~~ 2

3

= Nu NS NW
~g *

Ts
rec SNS a’ 2S

v2
i, The ah, Th "En
OY “me Ne Ne NN TS ts

dd > NN NN Ne NE NE NN, ny,
>= >

   

: ” > me, 25 ’ of rd

-
~
xX
™
bh
2
x
NN
Se
-N
XW ye

=
x

Avaaaswvry

   

THA i i a
J mas anns, » yonyge, A {
” tr Bt)
< y opref og
} Ire
"ANI
RW I
"trp yond
"ow it A wy
/ 2 ‘ Hn oF
" / A fun povisly
n Hn F/M) nar,
“fC Tey,
hor VRLD MR

7d
od RIG od?

PIN, ao
rus y pf
tA
YALA
.iia LTA 54 jpg smasiyl
"PIE
r / }” gfe. hogy
” nore A /
el “r
Cy
LY i
TRY
:
1

I™

gi

s
=

Bir

son
«=

eR 2
i *

x x

SAWN NNN

TS
:

eds ~~ dn
ogists ~~ =
Ce sxx
wr foc rvs

rng

Cll, =

be
3
4
~
t
3
x

>
5

Lor

RR

Yo
rr

?

 

v  asmang VeTIAR TT — wvy
Ch. 9]

of the reports which survive from the time
of the War of 1812, it is difficult to be
sure of the nature of all of the hospitals
serving the Army during that time. The
Tilton report of 20 August 1814, for ex-
ample, mentioned a return from a hospital
surgeon, E. W. Bull, concerning the sick and
wounded from Chippewa. It did not, how-
ever, make clear whether Bull was referring
to men who became incapacitated during the
battle of that name or to men hospitalized
at some facility or facilities at or near Chip-
pewa. If the former is true, however, the
figures furnished Tilton by Bull (approxi-
mately 900 wounded, 300 sick) are, as
Tilton commented, surprisingly high and
probably included, as the Physician and
Surgeon General commented, British casual-
ties. It is difficult to believe that 300 men
would fall ill as a result of one battle, and
therefore it is likely that the reference was
to the number of patients at a hospital.
There is no record of a general hospital
at Chippewa, however, but since the report-
ing physician was a hospital surgeon rather
than a regimental surgeon, it is reasonable
to assume that the Chippewa facility was a
flying hospital.t?

Patients at Fort Erie, which was taken
from the British in July, were cared for
by regimental surgeons who received high
praise in the summer of 1814. The men
there suffered from the high rate of illness
which was to be expected in the area, but
by early August, they were in better health
than had been expected. Not long there-
after, however, the British began an unsuc-
cessful five-week siege of Fort Erie, during
which a strongpoint blew up just as the
British were about to take possession of it.
The wounded left behind by the British,
their faces, in some cases, “so fearfully
disfigured, that the sight of them was
sickening,” were carried to the American
hospital. The care two surgeons and three
mates gave the men entrusted to them at
Fort Erie ?° led the commanding general to

Defeat and Final Victory: 1814-1815

177

comment upon their “active, humane, and
judicious treatment of the wounded, both
of the enemy and of our own.” 2!

The final report for the Medical Depart-
ment in the 9th District in the War of 1812,
covering the last months of 1814, noted
that in the right wing there were 174 men
remaining in regimental facilities and 210
in general hospitals, and in the Niagara
area, the left wing, 365 in all facilities. In
the vicinity of Sackett’s Harbor, the central
division, the total number of patients re-
ported to Tilton was 581, but he questioned
the accuracy of this figure.

In the Northwest’s 8th District, even after
the departure of Maj. Gen. William Henry
Harrison and approximately seven hundred
regulars for the Niagara front, surgeons were
unequal to the task which confronted them.
The same agues and fevers which severely
afflicted the civilian population in the area
of Lower Sandusky, Ohio, and the country
around Fort Stephenson struck at the gar-
risons holding the area. The physician re-
sponsible for the health of the soldiers here,
Nathan Boulden, regimental surgeon for
the 28th Infantry, also attempted to care
for the thirty families living near the fort,
even after he himself fell ill. He commented
that the low-lying land was “astonishingly
fruitful in the production of marsh
miasmata” and that there were occasions
when every member of a family was sick
at the same time.?3

Upon his arrival in the Northwest as
hospital surgeon for the 8th District late in
1814, another Army surgeon, Adam Hays,
commented that “there had been no kind
of system in this district, but I shall en-
deavor to cleanse the Augean stable.” He
emphasized the shortage of hospital sur-
geons, pointing out that the Army would
save money in the long run by sending out
two good hospital mates and three garrison
mates and thus eliminating the need to hire
private physicians with wasteful habits.2* By
178 THE
mid-January, however, the situation in the
Northwest had deteriorated to the point
where Boulden “fled for his life,” after
“having lost his health in the sickly region
of Sandusky,” and Hays was threatening to
resign because of a shortage of physicians
so severe that those who remained were
“worn out.” 2°

Although Tilton’s attempt to put the
Army’s medical services on a systematic
basis fell short of its goal and the care
offered the sick and wounded in the North-
west’s 8th Military was far from the ideal
in the 9th Military District where the Army
had concentrated both its most skilled
physicians and many of its finest military
leaders, by 1814 the picture was not entirely
a dark one. “Intermittent fevers, dysentery,
diarrhoea and jaundice” were regarded as
“endemic diseases” here,?® but because of
the efforts of both physicians and military
leaders, the only formidable sources of
disease in 1814 appeared to be new troops,
“the miserable refuse of society who never
had energy to demonstrate that they lived.”
“The mystical power of strict discipline and
rigid police” which could prevent even “the
demon diarrhoea” was now recognized 27
and utilized in both camp and hospital. The
recognition of the need for order and sys-
tem was already leading to improvements
in the care offered the sick and wounded
of the Army in the North.

In the districts of the North where there
was no military action, however, few pa-
tients required the attention of Medical
Department physicians. In the 2d District
(Rhode Island and Connecticut), for ex-
ample, at the end of 1814 thirty-five pa-
tients were reported to the Physician and
Surgeon General, all of them in a regi-
mental infirmary, while in the general hos-
pital of the 3d District (southern New
York State and adjacent New Jersey), there
were but fifty-eight patients remaining at
this time, twenty-two of whom were from the
militia.?8

ARMY MEDICAL DEPARTMENT,

1775-1818

CAMPAIGN IN THE SOUTH

The demands made upon the Army Medical
Department in the South, where relatively
few Regular Army units saw action during
the War of 1812, were quite different from
those encountered in the North. Unfortu-
nately, however, few of the surgeons on the
small staff in the South left records of their
work, and, as a result, only fragmentary
information is available on the activities of
department physicians below the Mason-
Dixon line.

During the War of 1812, most of the
area below the Mason-Dixon line lay in the
Sth, 6th, and 7th Military Districts and,
after the summer of 1814, in the newly
created 10th Military District, which in-
cluded the District of Columbia. (Map 12)
At the end of 1813, there were a total of
four hospital surgeons, six hospital sur-
geon’s mates, one garrison surgeon, and
six garrison surgeon’s mates assigned to the
first three of these districts. In the following
year, a fifth hospital surgeon and five more
hospital surgeon’s mates were added to the
staff in the South, but, even so, there were
fewer physicians assigned to the hospitals
and garrisons of the entire South than to
the northern 9th District.??

In anticipation of an enemy attack upon
Washington, the 10th Military District was
formed on 2 July 1814, to include the
area from Baltimore south through northern
Virginia, and Brig. Gen. William H. Winder
was placed in command. Estimates of the
number of men, both militia and regulars,
vary, but the latter did not exceed 500
and may have been no more than 300.
More than 93,000 militia were alerted, but
the entire force at General Winder’s disposal
at the time of the British landing near Bene-
dict, Maryland, on the Patuxent River on
19 August probably did not exceed 1,700
men.

Although approximately five thousand to
six thousand Americans, a large majority of
 

 

  

 
    
  
   

    

 

EAST

7 FLORIDA
2, (Spain)

MAP 12

     
  
  
 
   
  
   

WASHINGTON, D. C.,

 
  

1

 

> ILL. / IND. ( Richmond
Soul Term. (TERRA VIRGINIA
MISSOURI oo KENTUCKY £ ar
TERRITORY - - = Nop
2 = , CAROLINA
$ TENNESSEE ry TN
£ IE
8 ry i — Ho — \ SOUTH
Fort Strother N CAROLINA
MISSISSIPPI
S$ GEORGIA ©
TERRITORY J
Natchitoches
0 Fort Stoddert
Ng
LOUISIA gees ( o
Orleans,

 

   
 
 
  

 

 
 
 
   

SISI-FI8I K401014 [pul puv 1vafoq [6 40

6L1
180 THE
them untrained militia and volunteers, were
in the vicinity of the capital by 24 August,
the British won an easy victory in the Bat-
tle of Bladensburg and then moved on
Washington to burn the Capitol, the White
House, and other government buildings
before withdrawing to their ships and re-
embarking on 30 August. A British attack
on Baltimore in early September was de-
feated by militia and volunteers, without
the aid of regulars except for those at Fort
McHenry, where 24 of 600 regulars were
wounded and 4 killed.?"

Several facilities appear to have cared for
the Army’s patients in the summer of 1814
in the vicinity of Washington, D.C. One
Army hospital, under the direction of Dr.
William Jones, who was probably a hos-
pital surgeon’s mate at the time, was
operating at a location described as Green-
leaf’s Point, now the site of Fort McNair
at the junction of the Potomac and Ana-
costia Rivers, as carly as the fall of 1813.
The care offered soldiers before the summer
of 1814 in what would become the 10th
Military District nevertheless seems to have
left much to be desired and the establish-
ment of the new district does not appear to
have markedly improved it. The day before
the Battle of Bladensburg, Physician and
Surgeon General James Tilton complained
that the district was in great disorder
largely because no one was officially in
charge of medical support there. He urged
the appointment of a hospital surgeon to
provide leadership and proposed a personal
visit to the area. Although it appears that
it was not until 1 October that a hospital
surgeon was moved to the 10th District,
within three months he was able to bring
at least some order to the management of
medical support in that area.?!

Because of the absence of a hospital sur-
geon in August 1814, wounded from action
in the Washington area were apparently
placed under the overall supervision of Dr.
Hanson Catlett, who was referred to in a

ARMY MEDICAL DEPARTMENT,

1775-1818

House of Representatives report as ‘the
superintending surgeon.” He is listed in the
official records as the regimental surgeon
for the 1st Infantry *2 and referred to him-
self as having been specifically “attached to
the suite of General Winder, as staff sur-
geon.” ** Shortly after the Battle of Bladens-
burg, Catlett went through the British lines
to aid in the care of injured American
prisoners. Two other American physicians,
at least one of whom was apparently him-
self also a captive, aided him here. By 2
September, the hospital Catlett had been
ordered to set up on Capitol Hill was ready
to take all the patients who might be sent
there. When the British reembarked, they
left several surgeons and their most seri-
ously wounded behind them, and these men,
too, became an American responsibility.
There is no indication whether any of these
prisoners were cared for in the Capitol
Hill unit, which was still in operation as
late as September 1814.34

In addition to the Greenleaf’s Point and
Capitol Hill facilities, there was also a
third military hospital in the District of
Columbia. Here some of the sick and
wounded, both American and British, were
cared for by a prominent civilian physician,
Dr. James Ewell, who was assisted by a
second civilian doctor. Ewell wrote that the
Acting Secretary of War had ordered a
militia facility established next door to his
unit. This “militia-murdering hospital” was
run by a surgeon’s mate who had barely
started his medical training at the time when
he was appointed to care for the militia’s
wounded. ??

By the end of 1814, the regular troops
in the 10th District were in good condition
but the health of the men of the militia
was reported to be suffering because of their
lack of discipline. The militia’s sick were
being discharged, however, and at the end
of the year there were only eighty sick in
regimental infirmaries and seventy in the
general hospital. By January 1815, the
Ch. 9]

troops still in the Washington, D.C., area
were again sickly and a hospital surgeon
was ordered to investigate conditions in a
small barracks “near the President’s
Square.” It was pointed out to this sur-
geon that the hospital at Greenleaf’s Point
was not filled to capacity and could accom-
modate more patients than it then held.3¢

Although regular units were also distri-
buted among garrisons and forts through-
out the deep South, many of the operations
there during the War of 1812 were, like
those in the North, conducted by militia
and volunteers. The men operating against
the Creek Indians in the Southeast begin-
ning in the summer of 1813 were reinforced
by regulars only in February 1814 when
the 600-man 39th Infantry Regiment moved
from Tennessee to Fort Strother on the
Coosa River in what is now northeastern
Alabama. (See Map 12.) On 28 May 1814,
Andrew Jackson was named major general
in the Regular Army to command the 7th
Military District, which included Louisiana
and the Mississippi Territory and, believing
that the British were planning a move in the
South, the Secretary of War began concen-
trating troops, both regular and militia,
there. By 1 July, there were reportedly
more than 2,000 regulars in the 7th Mili-
tary District 37 and militia was being raised
within Louisiana and neighboring states
for the defense of that area.

General Jackson did not remain in the
vicinity of New Orleans at this time but
moved against West Florida with both regu-
lars and volunteers. He did not return to
New Orleans until 2 December. On 10
December, the British fleet was sighted at
anchor not far from New Orleans, at a
time when the only regulars there were
elements of two regiments and an artillery
detachment, totaling six hundred to eight
hundred men or fewer.2® Militia and volun-
teer units continued to pour in, however,
and by 22 December, General Jackson had
more than 2,000 men at New Orleans.

Defeat and Final Victory: 1814-1815

181

The first engagement with the British at
New Orleans took place on 23 December
1814 and was followed by three more bat-
tles, on the 28th of December and the 1st
and 8th of January 1815. The battle of 8
January resulted in a decisive victory over
the British with only minor losses for the
Americans. On the morning of 19 January,
it was discovered that the British had slipped
away from New Orleans, leaving behind
eighty of their wounded.?® Minor clashes
between the British and Americans con-
tinued in the South, however, until mid-
February when Congress ratified the Treaty
of Ghent and brought the War of 1812
officially to a close.

Other than physicians accompanying mili-
tia and volunteer units and such of the
department’s regimental medical staff as
may have accompanied detachments of
regulars into the 7th Military District, the
medical staff in this district was composed
of a single hospital surgeon, who was sta-
tioned at the general hospital at New Or-
leans, two hospital surgeon’s mates, whose
precise locations cannot be determined, a
garrison surgeon at New Orleans, and four
garrison surgeon’s mates, two of whom were
at Fort Stoddert, north of Mobile Bay, and
a third at Natchitoches, in west central
Louisiana. The location of the fourth gar-
rison surgeon’s mate does not appear in
the reports of the period.°

There was neither a surgeon nor a mate
assigned to Fort Strother, and as late as
December 1813, the 39th Infantry was
without a surgeon. It is likely, therefore,
that the medical care of regular units
based there during two successful months
of campaigning early in 1814 was provided
by a regimental surgeon’s mate.4! The
records of the medical care of General
Jackson’s men are very sparse, however,
and the few details which can be pieced
together concern the hospital and physicians
at New Orleans.

According to Dr. Oliver Spencer, the
 

 

=

EEA) ge

ra

|

|

|

5

i

:
Bf

i Lo

HERRERA RR
mang anna]
-_-

 

NEW ORLEANS IN 1815. Military hospital ai upper right corner. (Courtesy of Historic Urban Plans, Ithaca, N.Y.)

 

 

[43

aH I

FINIWLIVAA(Q TVOIAdN ANYY

8I8I-SLLI
Defeat and Final Victory: 1814-1815

183

 

THREE OAKS MANSION. (From Arthur, New Orleans.)

garrison surgeon for that post, before Gen-
eral Wilkinson’s last nine-month command
in the 7th Military District, which ended in
the spring of 1813, the general hospital in
the New Orleans area moved with the units
it served when they left the city itself.
Since that time and despite the “acknowl-
edged insalubrity” of the location, the fa-
cility had remained within the city, which
was known not only for its permeation by
“poisonous exhalations” from the river and
marshes but also for its “extraordinary
profligacy and licentiousness.” #2

Even before the War of 1812, the gen-
eral hospital at New Orleans was apparent-
ly located very near an Ursuline convent,
the unit’s presence having been described
as a ‘great inconvenience” for “the ladies
of the convent.” As early as April of 1812,
it had been suggested that the hospital build-
ing and lot be given to the Ursulines in
exchange for property which they owned

elsewhere, but as late as mid-June of 1815,
the trade had not been carried out, even
though General Jackson himself was in
favor of moving the facility outside the
city.

From time to time, other buildings were
apparently also used to shelter Army pa-
tients near New Orleans. During the action
around New Orleans on 8 January, hospital
facilities were set up near the field of battle.
It seems likely that a building was used
rather than a tent, since the hospital sur-
geon, Dr. David Kerr, later stated that
when the action was at its height, Louisi-
ana’s governor Claiborne rode his horse
behind the hospital, “where he was entirely
shelter’d from the balls of the enemy.” This
unit could have been the hospital set up in
late December in a mansion house outside
the city, one which was so damaged by this
use that, according to its owner, $550 would
be required to repair it. There was a man-
184

sion known as Three Oaks in this area
which served as a hospital during the de-
fense of New Orleans. Other patients were
cared for in the schoolroom of the Ursuline
convent, which had been abandoned by its
pupils on 23 December. Fifty beds were
reportedly set up there and it seems possible
that the sisters also served as nurses else-
where. #4

Kerr was the director of the New Orleans
general hospital during the last months of
the War of 1812 and as such was apparently
also responsible for collecting the required
reports from the regimental and garrison
surgeons and mates in the 7th District. Kerr
reported to Tilton, however, that as of 30
July 1814 he had been unable to acquire
reports from the other physicians in his
district, although there were forty-nine pa-
tients under his own care in the general hos-
pital.*®

References pertaining to the medical care
received by the troops defending New
Orleans are not always easy to interpret
because of a tendency to refer to participants
in the struggle by their last names only and
because there were two physicians with the
last name of Kerr involved. It is, therefore,
not always possible to be sure from the
context to which of the doctors Kerr refer-
ence is being made. By the time of the
British assault on New Orleans, Spencer had
resigned as garrison surgeon, but Dr. Chris-
topher Backus, of “the Drs. Apothecary
Generals department,” remained in the city.
A native of Louisiana, Backus had been ap-
pointed Assistant Apothecary General in
August 1814. Also aiding in the care of
the wounded near New Orleans was a Dr.
Flood, who appears to have owned land
upon which General Jackson’s line was at
one time camped and who seems, like John
Kerr, to have volunteered his services. Dr.
Lewis Heerman was a third volunteer whose
name, like that of Flood, does not appear
on the rolls of the Army Medical Depart-
ment. 46

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Because the climate was taking its
customary toll, the burden on the hospital
facilities in the New Orleans area in Decem-
ber 1814 and January 1815 was great,
despite the low number of American casual-
ties. Many contracted “pernicious fever and
dysenteries” and in one month 500 men
reportedly died from disease alone. Large
numbers of wounded British prisoners were
also the responsibility of the U.S. Army at
this time. The captives were taken to New
Orleans the evening of 8 January, but, since
the facilities there were already filled with
Americans, an appeal was made to the citi-
zens of the city for help. Pillows, old linen
for dressings, and 140 mattresses were
brought forward, and many civilians volun-
teered to take British casualties into their
homes and to care for them there until space
could be found for them within the hospital.
All civilian physicians in the city at this time
were called upon to care for the enemy
wounded. They appear to have responded
without hesitation and some even left town
and went out to meet the wounded to render
more prompt care.*” On 8 January, General
Jackson assured the British Commander that
“The wounded on the field shall be sought
after, and every comfort administered them
until they are recd.” 8

General Jackson also sent a friend who
happened to be a native of New Orleans
back to check on the condition of his own
wounded, who were scattered about the city,
but despite his concern, the death rate among
the hospitalized in New Orleans in the early
winter of 1815 was reported to be very high.
Militia and volunteer surgeons were ordered
retained in the service to care for their pa-
tients who were housed in Army hospitals.
General Jackson himself was on the sick
list at one time, laid low by a “serious attack
of disentry . . . brought on by cold and
fatigue.” His cure, achieved through the
efforts of “Doctor Kerr Hospital surgeon,” 4°
undoubtedly confirmed his earlier evaluation
of the care the sick and wounded received
Ch. 9]

during and after the defense of New Orleans
which had led him to conclude that “The
medical staff has merited well of the coun-
try.” 50

In the 5th and 6th Military Districts,
unlike the 7th, there were no major military
operations in the last year and a half of the
War of 1812, although enemy raids occurred
from to time along the eastern coast. In the
5th Military District, the headquarters of the
Medical Department was at Norfolk, an area
which the hospital surgeon in charge found
to be healthier than he had anticipated.
Assigned to Norfolk in 1814 were the dis-
trict’s only hospital surgeon, two hospital
surgeon’s mates, and a garrison surgeon’s
mate. There was also a garrison surgeon’s
mate at nearby Fort Nelson.?!

When the hospital surgeon at Norfolk
reported to Tilton in the summer of 1814,
there were but forty-three patients in his
general hospital and 618 in the “regimental
infirmary.” Elsewhere within the district,
however, there seems to have been much
confusion. The Deputy Quartermaster Gen-
eral in Richmond, Joseph Wheaton, main-
tained that he was forced to act as physician,
superintendent, and manager of hospitals in
Richmond from 1 January 1814 to 19
November 1817 2 because “there was no
hospital or medical department, nor even a
United States physician at Richmond” to
care for the many sick who, after their dis-
charge from the Army, went through Rich-

Defeat and Final Victory: 1814-1815

185

mond on their way from Norfolk. He had
personally taken the initiative, arranged to
obtain the use of a building for a hospital,
signed on a surgeon’s mate, and appointed
nurses. He apparently also supervised the
care of patients from the militia units in the
area.’

The troops in the Carolinas and Georgia
were served by a relatively large medical
staff, which as of 29 December 1813 in-
cluded, on paper, three hospital surgeons,
three hospital mates, and two garrison mates.
Tilton appears to have had as little success
in extracting reports from this district as he
had in many others.?*

The last year of the War of 1812 illus-
trated in the North the improvements in the
care of the sick and wounded which could
result from the effort and planning of ex-
perienced physicians when they were given
adequate time and resources. Hospitals there
were clean and efficiently managed and there
is no evidence that in the North they became
the hotbeds of infection which they had been
in the Revolutionary War. In the South,
where a high rate of disease was to be ex-
pected but where relatively few regular
troops were stationed, the situation was quite
different. Since casualties here were few
among American regulars, any unusual strain
upon the department’s physicians resulted
largely from the wounded militia, volunteer,
and enemy troops entrusted to their care.
10
The Lessons of War: 1815 to 1818

The experiences of two wars and several
expeditions against the Indians made it ob-
vious not only that Army surgeons, like their
colleagues everywhere in the late seventeenth
and early eighteenth centuries, were unable
to treat a large proportion of their patients
successfully but also that the U.S. Army was
unable to deliver the best medical care, as
determined by the standards of the time, to
its sick and wounded. After hostilities ended
in 1815, a number of surgeons published
journal articles about their professional ex-
periences during the War of 1812, but since
there was no central authority to coordinate
their observations or to study their con-
clusions and since they had little understand-
ing of the causes of disease and infection,
the significance of their contributions was
limited.

A number of the nation’s political leaders
were also brought by the experiences of that
war to urge the creation of a permanent,
professional, and quickly expandable Army.
Although their concepts failed to achieve
wide acceptance in the years following the
war and their efforts were to a significant
degree frustrated, a permanent Medical De-
partment was nevertheless established in
1818 when, as a result of the efforts of
Secretary of War John Calhoun, legislation
created a number of permanent staff depart-
ments for the Army. The disciplined, co-
ordinated collection and study of data
systematically gathered by the department
from different areas of the country and over
a long period of time now became possible;
as a result, as the value of statistical studies

received greater recognition, the department
would be in a position to make important
contributions to medical science. The exist-
ence of a permanent organization, further-
more, would also guarantee that a nucleus of
experienced and disciplined military sur-
geons would be available at all times in the
future to advise concerning the prevention
of disease and to care for the Army’s sick
and wounded.

INDECISION AND DECISION,
MARCH 1815 To APRIL 1818

The confusion and suffering caused by the
fact that the Medical Department was created
after the War of 1812 had begun and there-
fore could not prepare for the care of large
numbers of sick and wounded in the War of
1812 did not prevent the breakup of its
central organization within a short time after
the hostilities ended. The office of Physician
and Surgeon General was eliminated by the
legislation of 3 March 1815, which reduced
the Army in size to 10,000 men, but the
positions of Apothecary General and two
assistants, considered still needed because
of “principles of convenience and real
economy,” ! were provisionally retained
through an order of 17 May 1815. (See
Appendix K.) The ratio of one surgeon and
two mates per regiment was not altered,
however, and a maximum of five hospital
surgeons, fifteen hospital mates, and twelve
post surgeons per division was also per-
mitted. Many of the most experienced phy-
sicians were dropped, either temporarily or
Ch. 10]

permanently, from the service, even in those
instances when they had expressed a wish to
be retained. By the end of the year, however,
Secretary of the Army William H. Crawford
was urging Congress to recognize the fact
that the military should be given “in time
of peace, the organization which it must
have to render it efficient in a state of war.”
Even so, he did not suggest the creation of
the post of surgeon general, but merely pro-
posed that a permanent staff include an
apothecary general, whom he would have
stationed at Philadelphia.2

In April 1816, legislation was passed to
clarify the organization of the medical sup-
port to be provided the Army and the posi-
tions of the Apothecary General and his two
assistants were now made permanent. The
Army was divided into a Northern Division
with four geographical departments and a
Southern Division with five. A ratio of four
hospital surgeons and eight mates for each
of the two divisions was established, and the
position formerly known as garrison surgeon
was officially redesignated post surgeon. Al-
though there was now a small permanent
staff to handle the supply of drugs and medi-
cines, when John Calhoun became Secretary
of War late in 1816, there was still no single
superior over the entire department through
whom the Apothecary General, Francis Le-
Baron, could work in estimating the overall
needs of the Army’s surgeons.?

Apparently some critics of the medical
care available to the men of the U.S. Army
at this time blamed inadequacies in large
measure upon “‘the irregular and injudicious
mode which government has pursued in the
organization of a medical department.” Cal-
houn, however, was a young man of both
energy and ambition. He was convinced of
the necessity of expanding the work of his
predecessor in creating a peacetime staff
organization which would be able to meet
the challenge of war whenever it might come.
By April 1818, the new Secretary of War
was able to add to the permanent staff posts

Lessons of War: 1815-1818

187

of the Army that of the Surgeon General of
the Army Medical Department. *

At least twenty-two physicians who had
served with the Army during the War of
1812 informed Tilton, who himself retired in
the spring of 1815, that they wished to
remain in the Army. It appears, however,
that by January 1816, only seven of the
twenty-two had actually been retained in
any capacity whatever and that at least one
of the seven was very unhappy with the
position to which he had been assigned. One
of those who was dropped from the Army
commented to Tilton that “a just and honor-
able reward for public service is seldom
bestowed on the humane and faithful phy-
sician and surgeon.” Although he remained
in the Army, a second physician, Dr. J. H.
Sackett, who had served as a hospital sur-
geon’s mate during the war, joined those who
complained of the Army’s attitude. Sackett
had at first been dropped from the Army’s
rolls in May 1815, but after being asked to
remain the following month, was assigned
the position of a mere garrison surgeon’s
mate.’

Despite the fact that Dr. James Mann, in
Tilton’s words, “the oldest surgeon on our
register,” was recommended for reappoint-
ment by both Tilton and LeBaron, among
others, and wished to remain in the Army,
he was not initially asked to do so. He
appears, however, to have remained on duty
at least through mid-April. He became quite
bitter over what he regarded as the Army’s
unfairness, since he had a family to support
and had given up his private practice upon
entering the Army. By the spring of 1816,
however, he had apparently been reappointed
and was serving as one of the four hospital
surgeons in the Northern Division, along
with Benjamin Waterhouse, Joseph Lovell,
and Tobias Watkins.®

Even after hostilities ceased, large num-
bers of bills which Apothecary General Fran-
cis LeBaron had difficulty paying continued
to come in to his office. Among the expenses
188

he was required to handle were the costs of
care for the men who were treated by private
physicians after falling ill along the roadside
when units of the Northern Army were on
the march. Through the entire spring of
1815, LeBaron continued to press for the
funds he needed to meet the department’s
expenses, and during the summer the Sec-
retary of War decided that one way of
meeting some of these claims against the
department would be to sell off all hospital
supplies no longer needed.”

Early in 1816, LeBaron began to urge
measures to eliminate waste and extrava-
gance. Since surgeons were accumulating un-
necessarily large quantities of supplies,
specific regulations should be drawn up “for
the economy of supplies in this Dept.”
LeBaron’s problems continued, however,
and the spring of 1817 found him still con-
cerned about the accountability of surgeons
and others who handled supplies. He main-
tained that a one-quarter savings could
result if surgeons were made responsible to
the Apothecary General and the Apothecary
General in turn to “some higher source.”
He reported that he had been able, even so,
to save some money by having old instru-
ments repaired, but old medicines tended to
deteriorate and those of his drugs which had
been long in storage were losing in value
with every passing day. They should, there-
fore, be sold at once.®

Another economy suggested by LeBaron
in March 1815 was a consolidation of hos-
pitals to reduce the cost of transporting
supplies. The Apothecary General urged
that the men then in facilities at Burlington,
Brownville, and Williamsville be sent to
Greenbush, but he agreed with Waterhouse
that an invalid hospital should be opened to
serve the northern and western states. His
suggestions, however, appear to have been
to some degree ignored, since the hospital
at Brownville was in operation as late as the
fall of 1817 and that at Burlington was
still open when the hospital surgeon who

THE ARMY MEDICAL DEPARTMENT,

1775-1818

was in charge there in the winter and spring
of 1815 left the Army that summer.®

LeBaron made a number of other sug-
gestions for improving the efficiency of the
department’s supply system, but it is not
always possible today to ascertain to what
extent his ideas were carried out. He appears
to have succeeded to some degree in limiting
the frequency of supply deliveries to any
given area to once a year and hoped that, as
a result, he would receive fewer of those
small orders which could be easily lost. He
requested that estimates of need be made up
by March of each year, pointing out that
timely returns could have saved $10,000 of
the $36,000 to $37,000 which was spent on
drugs in the twelve-month period ending in
the summer of 1817.10

The path of distribution of supplies to the
regimental surgeons lay through the quarter-
masters at such central points as Philadel
phia, Boston, and New York. In early 1815,
for example, the assistant apothecary general
assigned to Richmond, Virginia, was receiv-
ing all of his medicines from the deputy
commissary in that city. There was at least
one request that a storage depot also be
established at Baltimore, but LeBaron be-
lieved that taking this step would unneces-
sarily complicate the handling of supplies.!!

LeBaron hoped to take advantage of water
transportation wherever he could. With this
in mind, he pointed out that New York City,
where he wished to make his headquarters,
was an ideal location. He apparently ex-
perienced difficulty in receiving permission
to make the move and in the spring of 1816
was still urging that this step be taken. He
pointed out to the Secretary of War that the
rivers leading to the west from Philadelphia
could be used for transport from a depot
there and that New Orleans could serve as a
center from which the deep South could be
supplied. LeBaron’s work was complicated,
however, not only by such occasional prob-
lems as the “uncommon scarcity of Water of
the Mohawk” but also by the fact that he
Ch. 10] Lessons of War: 1815-1818 189

£7, r For Cou bl i , Fk 23 % ° , ,
Dclirien \ Yespica Ji rilees teehee He gottmar 5 1d ana tegimenf a slay Sei

“on Jie, ND and Sora led bop fue obese Ten IMI ler Gent o Ties. om 7) of cltslinileoce, vey. -
: / 7 7

 

 

 

 

 

 

 

 

 

    
  

 

 

 

FY a } J -
Sf ? Uy rife i“ Filed locke, itt Ceri mr SoAd ! Trede, fod ymve Fe
$4 fast Genine Giron, Spuckl) 20 Gat? | “oGal” i ol 2 Lert gual, cmsfe ki
G4 Galt Pod line I guntly| 10 fal” | mofarr Valo i
32 Gat” Sherry lv JE fui? | Ze Ja £? lo jrdi — (Herh gustd on Pradid raf
Dal fink fF lminind  20fat | 2 fet | fil RE es
236 # Hubra Rake, ER [266 id Tow pent
AIH Lhd ye Fen | pif gem [AB Feakesghitpentt
S28E Aue fon Mri | 96% | led emcy
~ITmlnf lyn fps] vty | 4% | 2% leurs
100 BGhocolel Speeiy 3,0 0% 20% I unt cinfed
2% Gafria. pl i » 7” 2” Be .
EB prow 28 2h 11x i ot
ET as] 2s oT :
$05 Ditnengr | 9%... 1 4% Bw punts —
Orders at fs 1ame Limp Hene AH, ttre tet rn, Dr Khrit Ba cins A "Gp Saori a Peder lane,

G fuurihars Ko folloutiy Aids at Hew OV loans Ramps pt ppc SR Sul uality LS

 

 

 

 

 

___Pnetafoue __rotipu neler ele | Dargesty
__Osrwn Sugar Rr ye. Shs fig LYpren fafa | Berpunlly
> ow lice TewPia | Ry Pie | bot - )
Regpusites A Goma ily Battin Frome Byer 76 dered Fhe rel
Morekee fur at 0% aA fad floreass i 9 Hora) Biding :
—2003lasketly | 843 lankatt | 100 baskets
20 Shey | 12 huts | Tiss |
W Rea focks | phe fick, | j0BObK | sore fuk, | wih
20 Citew Bases | 108m Jo Pur patio us|
Fecsrfouts Thect Ti; apfilse ying wmilit nel oc dghicintf Suter Bs Sok Fettnes 8 ves PN Mere

Af Rework % Jack wh Ha fa ne goa bt
Gupe frat 7 mate 13:
, melee, of acononly aborc

dmale Blandats, ~folece, RE A.

Aig MAD a

rt

7 cau Sint ragk 49 alone reitionsd, Se Fz, 7
hath in Mire,
. All beer fFioa Sa
ADD fw T loves unt) Sore’ Phen were
DBA, tuk of Hh tare wi Fe 13 ——
ATED F eal ATi of Hof Soran fren mind Suite fldge Sigs ely sfoonT; avd He
§ ele As BD Dion Braemar iy Ind :

% ne
“ds Tow Jomall 7% Soue % Soliirs & of 18>
Te S28 ff ar TA ret of Zoo %
fat nade uf 3

Ke rermartc

|

pA
A ffrdaoda

% tack Yh obo many Cl, lug? gn are Boa Measmisres, Riot ZTCE but Boil filed g. Frpeaty &

du paty HiT

dont fu Jones

by KT mak in Rasy He fats
forse 671; fa at abi fois, Satins §

v wire PH frat puns & con Revs Sveey Lb, JH PE Ae bli link Abin
Jam CS icse those
ith iid

Stare
ly

Pos oTE5r, Case. —

Sfp lel on Ho SGI Fihle, of] pari yo
¢ Leck, fou tensa ¢ AH Se 0 rapollact hugs TD JOTRGT mo meslat can. Kagfoom —
Furia k IF tap

ponds  § 7 meh

evuld alia, be basrcisd

stil usin, ion ate hair Point didias, a ol
com pitb) te Fe i, fia

Lp
oii anni

Cos YYrtif Fon?

Pasion SV potty Guouny g 5: 53)

STATEMENT ON HospPITAL SUPPLIES SENT FROM NEW YORK. (Courtesy of National Archives.)
190

could not be sure what forts were in use at
any given time.!2

The Apothecary General made an inspec-
tion trip in the late summer and early fall
of 1816. It was planned to take him along
the northern frontier, which was in an “un-
settled state” as far as the Medical Depart-
ment was concerned. He hoped to visit
Brownville, Sackett’s Harbor, Niagara, and
Detroit, and possibly Michilimackinac as
well. When he learned that the men con-
structing a “military road” near Detroit
would probably suffer a high rate of disease,
LeBaron decided to take two wagonloads of
items which they might need along with him
when he left Albany. He seems to have set
out upon this three-month voyage in the
late summer of 1816, but in addition to
being “sick most of the time,” he was ship-
wrecked on Lake Ontario.!3

Despite his efforts to improve the supply
operations of the Medical Department, Le-
Baron’s position was made insecure by con-
tinuing criticism of the quality of the sup-
plies he sent out. In February 1817, although
the exact nature of the complaint was not
spelled out in the Secretary of War's letter
to the Apothecary General, LeBaron was
tersely informed that if there were further
complaints on this score, “the government
[will] . .. discontinue your services.”

Much of the work of Army surgeons in
the period immediately after the end of the
War of 1812 involved the sick and wounded
still remaining in need of care or new pa-
tients from among the troops originally con-
centrated as a result of the war. In February
1815, for example, there were still “sundry
considerable armies & cantonments” in the
9th Military District. As late as March there
were also sick and wounded British prison-
ers in a hospital at Pittsfield, Massachusetts.
Even in 1817, Army surgeons were still
concerned with the veterans of the War of
1812. The certificate of an Army physician
was required for some types of pensions,
but apparently not all of the certificates

THE ARMY MEDICAL DEPARTMENT,

1775-1818

issued were accurate. In at least one in-
stance, a surgeon stated that a man had
been wounded in action at a time when
the individual had not yet joined the Army.
The physicians involved, however, were not
accused of fraud but rather of a lack of
awareness which made them the easy vic-
tims of dishonest soldiers.!®

Although there were still patients requir-
ing care in the vicinity of Lake Champlain,
Dr. Henry Huntt was on leave and Mann
was attending the court-martial of Maj. Gen.
James Wilkinson at Utica, leaving no hos-
pital surgeon on duty in this area. By April,
however, when Mann had returned to Platts-
burg, the men were in excellent health, a
fact he attributed to the “rigid discipline
and judicious police” which prevailed among
them. He also noted that the regimental
units were well managed. Huntt was ordered
to the general hospital at Burlington early
in February 1815, but in June he was re-
lieved of duty there and left the Army.!®

By the end of June 1817, Dr. Joseph
Lovell appears to have become, at least
unofficially, the head of the Northern Divi-
sion. He turned in a report of that date
which was entitled “Remarks on the Sick
Report of the Northern Division for the
Year Ending June 30, 1817” '" and later
that fall was referred to as “Inspecting hos-
pital Surgeon, at Head Quarters.” '® As a
result of his inspections he was able to
report that the health of the men in the
North was very good. More than 2,100
patients had been treated in the preceding
twelve months, 838 of whom were suffering
from fevers “and other important com-
plaints,” 193 from wounds, and 55 from
venereal diseases.!?

THE STATE OF THE ART

Two wars and a number of campaigns
against the Indians offered the physicians
who served with the American Army be-
fore the spring of 1818 opportunities they
Ch. 10]

would not otherwise have had to observe
diseases and their treatment and the effects
of climate, weather, and geography upon
health. Some of these surgeons attempted
to record either formally or informally for
the benefit of others what they had seen
while in the Army and the conclusions they
had reached, but the speedy disbanding of
the Medical Department made the most
effective use of their professional experi-
ences during the war impossible.

Most of the observations of the military
physicians of this period seem to have been
directed at the practice of medicine rather
than that of surgery. Concern continued
to be shown for the prevention of disease,
through improved hygiene and, in the case
of smallpox, through the new process of
vaccination. The prevalent types of treat-
ment were also examined with a critical
and discriminating eye.

Vaccination was not used within the
Army with the enthusiasm which might
have been expected, despite the fact that an
early supporter of the procedure, Dr. Benja-
min Waterhouse, joined the Army Medical
Department during the War of 1812. Since,
in addition, no deliberate effort was made
to study the effectiveness of the procedure,
a valuable scientific opportunity was lost.
LeBaron, as Apothecary General, attempted
in late April of 1813 to have all nonimmune
troops vaccinated and urged that the ma-
terial necessary be sent out at once so that
all susceptible men could be immunized be-
fore the new campaign began. Although he
sent out the “vaccine virus” to various
commanding officers, LeBaron did not
have the authority to order the troops
to undergo the procedure. He made no
reference to the existence of any smallpox
within the Army, but pointed out that im-
munization was necessary because some of
the localities through which the troops
would have to pass were experiencing small-
pox epidemics. He emphasized that no
special preparation was deemed necessary

Lessons of War: 1815-1818

191

before vaccination and that after the pro-
cedure had been completed, the men could
continue with their normal routines.2°

Not long after he became head of the
Medical Department in 1813, the Physician
and Surgeon General appointed six young
surgeon’s mates to form a vaccinating
team to go out to immunize the Northern
Army. Like LeBaron, however, Tilton made
no mention of any smallpox epidemic with-
in the ranks of the Army. Whether the
mission he assigned was actually accom-
plished cannot be ascertained, but the next
summer Maj. Gen. George Izard, alarmed
by a single case of smallpox within his
camp, sent “an express” to Albany to ob-
tain “kine pox matter” and commented
that his troops should have been vaccinated
earlier.?!

Although none of these documents re-
fers to an epidemic of smallpox within the
Army in the War of 1812, the fear that
there might be one was evident. Since refer-
ences to devastating smallpox epidemics
were common in the documents of the
Revolution, and since the disease was still
dreaded, it is unlikely that similar epidemics
in the War of 1812 would go unmentioned.

Discipline as a key to the prevention of
disease was well recognized by the War of
1812 and was emphasized by the future
Surgeon General, Joseph Lovell, who
pointed out that one of the reasons for
retaining a “military establishment” in
peacetime was the fact that military ex-
perience was necessary to an understanding
of regulations and their importance. The
precautions recommended for the prevention
of disease included not only the obvious
sanitary measures but also the locating of
camps in dry areas and the starting of
fires early in the evening on the windward
side of camp if circumstances made the
pitching of camp in a damp area unavoid-
able.??

Proper clothing was considered to be
very important. No new conclusions on the
192

subject appear to have been reached dur-
ing the War of 1812, however; faith was
still placed in the wearing of woolen shirts,
particularly north of Philadelphia, and
Lovell recommended that the advice of
Benjamin Franklin on that subject be fol-
lowed: woolen shirts should be worn “until
mid-summer” and put on again “the next
day.” Surgeons in the War of 1812 were
apparently also familiar with the damage
which cold and damp could cause to the
feet. Lovell emphasized the importance of
proper footgear, commenting that “the most
important circumstance perhaps of all is
to enable the soldier to keep his feet warm
and dry by a liberal allowance of woolen
socks and laced shoes, reaching at least to
the ankle.” Lovell also believed, however,
that letting the feet remain wet and cold
for any length of time had “deleterious
effects upon the constitution through the
lungs and bowels.” 2 Tilton shared Lovell’s
faith in flannel worn next to the skin, but
he believed that wearing clothing which was
too warm in the summer was also unwise.
In hot weather the soldier should wear
“pantelets & shoes, without stockings,” but
in every kind of weather, he should wear
gaiters.?*

Mann’s experiences, however, had not led
him to great optimism concerning what pre-
ventive medicine could accomplish with the
average soldier. The Army enlisted many
men who were already “habitually intem-
perate, with constitutions broken down by
inebriation and its consequent disease;
whose bloated countenances exhibited false
and insidious marks of health” and these
“contribute to fill our hospitals.” “It has
been too much an object with officers on
the recruiting service, to fill up their rolls
with numbers.” “The surgeons of the army,”
Mann lamented, “are made mere scape-
goats, on whom are heaped a multitude of
sins.” 2%

Although hospital records surviving from
the War of 1812 list fevers and digestive

THE ARMY MEDICAL DEPARTMENT,

1775-1818

and respiratory ills as the most prevalent
discases, some patients suffered from
“nothing” or even “rascality.” 2 One Army
surgeon, however, recommended a cure for
this kind of ailment. Blistering, he said, was
“a good test, in doubtful cases, whether a
man was really sick. Rather than submit to
the pain of blistering a second time, unless
absolutely diseased, he would prefer going
to duty . . . so that, whether a man was
actually sick or only feignedly ill, blistering
was an excellent remedy.” 27

If there were a disease deserving of the
name of “camp disease” in the War of 1812,
Lovell believed it would have to be diarrhea
and dysentery. The primary cause of this
problem was, in his opinion, not bad food
or water, but cold and damp weather. To
treat diarrhea and dysentery, physicians
tried inducing perspiration by warm baths,
warm drinks, warm coverings, and medi-
cines believed to increase perspiration, such
as Dover’s powder, a combination of opium
and ipecac.?®

Another goal of the physician treating
dysentery was the emptying of the digestive
tract by purges and emetics, an approach
which was accepted with little or no ques-
tion. There seems to have been some dif-
ference of opinion, however, on whether
the purge should precede or follow the
emetic. Waterhouse believed that ipecac
should be administered before the purge,
and that jalap, senna, aloes, rhubarb, and
“perhaps calomel” should not be used for
purging the sufferer from this disease be-
cause they increased ‘peristaltic motion.”
Epsom salts, manna, castor oil, and extract
of butternut, on the other hand, were ap-
propriate since they operated by “increasing
the secretion of the glands of the intestines.”
Heustis, however, favored administering the
purgative, preferably castor oil, before the
dose of ipecac or tartar emetic. For severe
and chronic dysentery he also recommended
the raising of blisters just above the ankle
and the administration of 1.5 to 2 grams
Ch. 10]

of opium, to be combined in the case of
heavy drinkers suffering from this disease
with 2 to 3 grams of sugar of lead. Water-
house used opium only when his “patient
has been thoroughly evacuated,” but ad-
mitted that the sufferer’s pain alone might
make the use of opium necessary.?® Mann,
however, warned that the sudden checking
of chronic diarrhea could bring on dropsy,
which was best relieved by “drastic
purges.” 3° Waterhouse also recommended
the use of “decoction of wild cherry” as
an ‘‘astringent in the latter stage of dysen-
tery.” 31

Neither Waterhouse nor Heustis seems to
have believed in the unrestricted use of
bleeding for dysentery and diarrhea. Heustis
stated that only feverish patients should be
bled, while Waterhouse recommended
venesection only when the sufferer was
young and had “a very hard and crowded
pulse,” accompanied by “severe pains in
his back and loins.” Even in these instances,
however, Waterhouse warned that patients
should be bled but once.3?

There was considerable agreement on the
appropriate diet for the patient with diarrhea
or dysentery. Heustis and Waterhouse
agreed that meat in any form should be
avoided, along with alcohol. Heustis en-
couraged the use of ripe fruit, especially
mangoes, guavas, and pomegranates, for
“scorbutic dysentery,” while Waterhouse
emphasized that the fruit must be truly ripe
since green fruit would have a harmful ef-
fect. Heustis favored a milk and vegetable
diet for these patients,®® and Mann added
that “No article prescribed proved so bene-
ficial as milk and its preparations . . . By
milk alone, it was my persuasion, that many
lives were saved, which, without it, would
have been lost.” 34

Physicians in the early nineteenth century
continued to question whether many of the
fevers so prevalent among the Army’s pa-
tients were separate entities; nothing of
significance had been learned about these

Lessons of War: 1815-1818

193

diseases since the time of the Revolution.
In 1817, for example, Heustis wrote:
“Briefly, my opinion is, that the intermitting,
remitting, yellow fever, and plague, are
only gradations and modifications of the
same disease.” In 1813, Dr. John Warren,
who had served with the Hospital Depart-
ment in the Revolution, speculated as to
whether the disease known in the tropics
as yellow fever was identical with typhus,
although he was confident that the yellow
fever which struck Boston in 1798 and
1802 was not typhus. Warren did distinguish
between inflammatory fever and typhus, but
he seems to have used the terms typhoid
and typhus almost interchangeably.®> A
physician thus might describe a fever as
being “a typhoid type” and characterized by
a “total loss of appetite, great thirst, parched
brown tongue, sordes on the teeth, increased
heat of the skin.” 3¢

By 1817, studies arising from the inter-
est in the possible effects of weather and
climate, however, seem to have somewhat
lessened the prevalent enthusiasm for the
idea that the origin of fevers might be in
“those changes in the air that are pointed
out by the thermometer, barometer, or
hygrometer.” Waterhouse began to believe
that the origin of these “wide spreading
maladies, as well as endemics, or local
disorders” lay in “some secret movement, or
alterations in the earth, or on its surface.”
He noted that while “Epidemics seem to
accompany or follow a blighted state of
vegetation,” they also seemed “to accom-
pany an abundant harvest, but whether in
the series of cause and effect, is not fully
known.” He then terminated his discussion
with an abrupt “As to myself, I'm weary of
conjecture!” 37 Not long after the permanent
organization of the department, Army sur-
geons would be required to begin contrib-
uting detailed and systematic reports to
the study of the question Waterhouse and
others had raised.

Although the physicians of the early nine-
194

teenth century may not have been sure of
the identity of typhus, at least one left a
particularly vivid picture of the effects upon
a patient of a disease to which he gave
that name. Describing a case he had en-
countered in the vicinity of Niagara, Lovell
wrote:

In the course of the 4th week, a small cir-
cumscribed spot of inflammation shewed itself
in the face, generally, near the angle of the
mouth. In a few days, the side of the face
swelled; this tumour was very hard and pale,
resembling the colour of a white swelling of
the joints. It was not in the seat of the parotid
gland but anterior to the branch of the lower
jaw, and was attended with a most profuse
and fetid salivation . . . . In a few days more,
the red spot began to assume a vivid appear-
ance, and symptoms of incipient mortification.
In a short time the mouth was literally ex-
tended from ear to ear, exposing the backmost
grinders on both sides.

Lovell ruled out the use of mercury as a
cause of this horrible disfigurement, point-
ing out that “in the majority of these cases,
not a particle of mercury had been used in
any form.” 38

The treatment of whatever diseases might
have been included in the term “typhus”
varied. Lovell noted that militia doctors in
the summer of 1814 treated it by blistering
“the patient almost from the crown of his
head to the soles of his feet; so that the chief
difficulty was to remove the irritative fever
induced by this empirical, slovenly practice.”
Some physicians also placed great reliance
upon mercurial medicines *® and still others
upon the use of leeches and cupping, al-
though they might believe that venesection
itself was harmful and had in some instances
“destroyed patients.” 40

When treating fevers described as inter-
mittents, Mann resorted to bleeding and
also reported the use of medicines other
than “bark” (by which, presumably, he
meant cinchona bark), including aromatics,
bitters, wine, snakeroot, and arsenic com-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

pounds; Lovell commented that he had been
unsuccessful in the use of bark against a
tertian form of intermittent. Mann also failed
to relieve tertian intermittents with bark ex-
cept when the patient was already conva-
lescent, although he had used “an arsenical
preparation” with this type of fever and it
had “acted almost like a charm.” Lovell,
on the other hand, observed that intermit-
tents which responded to arsenicals in 1813
had not done so in 1814.#! The question of
the best drugs and dosages to use against
malaria was to be taken up by the depart-
ment and thoroughly studied with the aid
of data collected from surgeons in the
field after the permanent organization of
the department in 1818.

By mid-1817, however, intermittents were
for some reason no longer being seen with
any frequency in the North except in the
new 5th Military Department and particu-
larly Detroit. Lovell’s report of 30 June
1817 listed 164 cases of intermittent fevers
in the North, of which 141 were in the
5th Military Department, 120 in Detroit
itself. In the same report, Lovell listed 266
cases of inflammatory fevers, including colds
and pleurisy, “which no ordinary care can
prevent.” 42

Among other conditions mentioned in
the records of this period was epilepsy,
which Mann treated at Burlington with ni-
trate of silver. He concluded that “By this
medicine alone, the morbid action, which
constituted the disease, was entirely sub-
dued.” #* Mumps also appeared from time
to time in the Army, and on one occasion
Hanson Catlett maintained that it had been
brought on by “exposure to severe cold
weather, & storms of snow & rain, which we
have had for some days past” at Fredericks-
burg, Virginia. Catlett maintained that
mumps might prove fatal on this occasion
unless the men were moved to drier quar-
ters.

On some occasions, Army surgeons used
autopsies to further their understanding of
Ch. 10]

the diseases they were encountering. Water-
house recorded that postmortems on pa-
tients who died of dysentery showed him
small ulcers all along the lining of the
victim’s intestines. He concluded, as a re-
sult, that dysentery “is to the intestines
what smallpox is to the skin.”*> Mann de-
scribed many autopsies done in late 1812,
in 1813, and in early 1814 upon patients
who died from the prevalent “pneumonia
notha.” 46

By the end of the War of 1812, some
surgeons who had cared for troops in that
period were beginning to have reservations
about a number of the remedies used.
Opium, of course, was suspect because of its
potential for causing “an interruption of the
natural actions of the small intestines.”
Since it ‘“‘corrects nothing, expels nothing;
and only assuages and benumbs,” opium
was apparently not highly regarded.*” Sugar
of lead, however, “was, at one time, a fash-
ionable remedy among the surgeons of the
army for chronic diarrhea.” Surgeon Henry
Huntt was familiar with a patient who used
this remedy extensively for the better part
of a year. Over that period the victim slowly
developed constipation, loss of appetite,
“profuse perspirations,” an abscess on one
leg, an ulcer on the other, and ever more
violent pain. Before death brought release,
he had become completely paralyzed. Al-
though Mann noted that sugar of lead, like
opium, could also lead to dropsy, Huntt
placed the blame for its adverse effects not
so much upon the medicine itself as upon
its use in a fickle climate.*®

The need for care in the use of mer-
curial compounds was now also recognized
by at least some Army surgeons, since
misuse could lead to the “destruction of not
only the muscles, but the bones of the
face.” Mann recorded “Four cases, under
these formidable effects of mercurial ptya-
lism” who were admitted to the Lewiston
general hospital. Of these, three died with
their jaws and faces dreadfully mutilated.

Lessons of War: 1815-1818

195

The fourth recovered, but with the loss of
the inferior maxilla on one side and the
teeth on the other. “He lived a most
wretched life . . . incapable of taking food,
except through a small aperture in place
of his mouth.” Mann doubted, furthermore,
that calomel administered during a cam-
paign ever completely cured syphilis. He
suggested that it should be used only after
the troops had entered winter camp, since,
if carelessly used in the field, it was “fre-
quently injurious to the bowels.” It should
never be given to patients “when exposed to
cold and moisture,” since if the skin could
not be kept warm, ‘either the bowels or
the glands of the mouth suffered.” 4°

Reservations concerning such time-
honored remedies as the antimonials and
venesection were also now being expressed.
Mann urged that the former not be used
when the men were being sheltered from
changeable weather in tents, and Waterhouse
pointed out that although “If a thick muscu-
lar part is inflamed, we can, at once,
remove that inflammation, by taking off its
tension, by bleedings,” “if the mucous mem-
brane, lining any internal cavity, more es-
pecially of the intestine, be inflamed, we
cannot take off its tension by bleeding,
without hazarding life.” 5°

The Army’s physicians of the early nine-
teenth century did not often comment on
their experiences in the field of surgery. Ap-
parently little surgery was performed outside
the areas of major military activity; in the
3d Military District during the entire war
only two amputations and one operation
for the correction of hydrocele were re-
corded. When surgery, such as the setting
of broken bones, became necessary at posts
where there was no surgeon, the procedure
might well be done by someone without any
training whatever. Mann was very much
concerned about the quality of the surgery
which Army surgeons were performing and
urged that his colleagues pay particularly
close attention to the work of the famous
196

French military surgeon, Dominique Lar-
rey.’

One surgeon, W. E. Horner, in the 9th
Military District where most of the action
of the War of 1812 took place, wrote a
series of articles on the surgical cases he
had encountered and the conclusions he had
drawn from them. He noticed, for example,
that buckshot wounds rarely proved danger-
ous unless a vital organ was hit and that
bullet injuries which hit neither bones nor
the “great cavities” also did not usually
pose a great problem. He believed that the
large size of English musket balls made
amputation necessary when one of the
“large cylindrical bones” was hit.

Major amputations posed a number of
further problems. The onset of hot weather
greatly decreased the patient’s chances for
survival; mortification quickly set in, mus-
cles retracted to an unusual degree, and
many patients died. There was still con-
siderable debate over the advisability of
postponing amputations. Horner believed
that if a patient did not have to be moved,
it might be wise not to inflict the shock of
amputation upon a man still suffering from
the shock resulting from his wounding. In-
deed, if a limb had been torn off, something
could be said, he maintained, in favor of
letting nature take care of the situation,
since “by her law if a bone protrudes beyond
the limit of its covering by muscles and
skin, she in a few weeks, reduces its length
to the proper mark by the process of ex-
foliation.” 53

Horner was familiar, however, with Lar-
rey’s preference for immediate amputation
and credited the French surgeon as well as
his English colleagues with the preference
Americans showed in favor of early opera-
tion, even when they were familiar with
instances during the War of 1812 when the
survival rate among those whose amputa-
tions were temporarily postponed was higher
than that among those whose surgery was
performed at the first possible moment.®*

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Among those undergoing amputation who
were discussed by Horner was one patient
who greatly puzzled him. This soldier under-
went the excruciating procedure with com-
plete serenity, “smoking tranquilly during
the whole operation; his ease not seeming to
be an affectation,” while his leg was re-
moved.%?

Several physicians with experience gained
in the War of 1812 criticized the plan de-
veloped for a military hospital by Tilton
during the Revolution. (See Chapter 5.) Sur-
geon William Barton was vigorously op-
posed to Tilton’s design and, in a “treatise
on various types of military hospitals,”
ridiculed Tilton’s notion that earth floors
and a center fireplace without a chimney
would reduce the spread of disease. He
maintained that wooden floors were entirely
safe if kept clean and thickly covered with
sand and added that he did “not think
any plan was ever conceived, so fraught with
mischief as this; and which certainly does
not reflect either credit upon the inventor’s
ingenuity or discernment.” Barton was ap-
parently unaware of the existence of Tilton-
type huts at Brownville, New York, where
the surgeon in charge was quite pleased
with the design, and at least one other
site, for he claimed that “not withstanding
the elevated rank of Dr. Tilton during the
war, his plan was never adopted by a
single surgeon.” ® There is no evidence,
however, that Tilton ever attempted during
the War of 1812 to have such a hut con-
structed.

Mann's experiences in the War of 1812
led to criticism of the Tilton plan which was
milder than that of his outspoken colleague.
He agreed that it was desirable that a hos-
pital, particularly a temporary one, be only
one story high, making proper sanitation
easier and eliminating possible disturbance
from footsteps overhead, but he disagreed
with his superior on many other aspects of
hospital design. Wood floors were warmer
than those of earth, he noted, and in hot
Ch. 10]

weather tents were better than huts. The
smoke which filled Tilton-style units ag-
gravated coughs and chest problems, and
unless the required lumber were standing
in the immediate vicinity, obtaining logs
needed for the Tilton units could be very
expensive.®?

As Mann envisioned it, a military hospital
should have windows on the east and west
and, “On the west, a closed passage should
extend the length of the hospital 12 feet
wide, into which the doors of the several
wards open.” This passage would shield the
western windows from the summer heat.
Within the building, each separate ward
should be thirty feet by twenty-four feet in
size and thus large enough to hold twenty
patients, with ceilings at least eleven feet
high. Since ventilation without drafts was
of great importance, hospital windows
should be double-sashed. Each ward would
require the attention of two nurses, unless
more were required to handle the cooking.
Wards for patients with contagious diseases
should contain fewer patients than other
wards, surgical patients should be kept
separate from those with fevers, and men
with either venereal disease or scabies
should be kept away from all others. There
should also be a separate room where pa-
tients about to be admitted could be washed
with tepid water and dressed in clean
linen.®8

Mann pointed out that while the medical
staff of each army on the move should be
prepared to set up a field hospital and to
provide transportation to this facility for
its patients, each permanent hospital should
have its own separate staff. In the temporary
hospital, instead of the customary bunks,
Mann suggested the use of ‘canvas bed-
bottoms, constructed with loops on the
side, through which pass poles for their
support. The bed-bottoms are supported by
stakes drove into the earth with a fork on
the top to support the poles, to which the

Lessons of War: 1815-1818

197

bottoms are attached. These beds may be
put up in a few minutes.” *°

Mann urged also the keeping of system-
atic hospital records concerning patients and
prescriptions, but he pointed out that, ex-
cept for the Burlington hospital in the
winter of 1813-14, this was not generally
done. Lovell, in his report of June 1817,
went even further than Mann and urged
that hospital surgeons and mates also keep
careful records of weather and local cli-
mate; he would later, as head of the de-
partment, require this of them.

In his Medical Sketches which appeared
in 1816, Mann discussed not only the prob-
lems of the individual military hospital but
also those of the Army Medical Depart-
ment as a whole. Since his opinions were
generally well received by his colleagues, it
is likely that they agreed with the emphasis
he placed upon the need for preparing for
the medical care of the nation’s soldiers
before the outbreak of war and also with
his plea for increased stature for the Army’s
surgeons. ‘!

Throughout the period from 1775 to
1818, the inability to plan ahead on a
long-range basis to meet the needs of the
Army’s sick and wounded had forced the
Medical Department to function in an in-
efficient and, too often, ineffectual manner,
handicapped by a lack of supplies and
housing and by surgeons who were to
varying degrees unresponsive to discipline.
In addition, innumerable opportunities to
evaluate the effectiveness of various forms
of treatment on a wholesale basis and thus
to advance the state of the art of medicine
were lost because of the lack of a permanent
organization to plan and conduct such
studies.

The lessons so painfully learned in two
wars and a host of Indian skirmishes finally
became too obvious to ignore. As the new
nation expanded with great rapidity and
Army units took up their duties increasingly
far from Washington, an ever greater need
198

arose to attract into the Army and train
physicians qualified and willing to work in
isolated areas on a permanent basis, To at-
tract and supervise such a staff and to plan
and coordinate not only the care of military
patients but also the highly valuable studies
Army surgeons would in the future conduct,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

a permanent central organization was neces-
sary. The establishment of the Army Medi-
cal Department on a permanent basis in
April 1818 was, therefore, a vital step
toward making the best care possible avail-
able to all the sick and wounded of the
United States Army.
Appendixes

APPENDIX

SOME INFLUENTIAL DOCTORS

HosrPpiTAL DEPARTMENT,

A
IN THE CONTINENTAL
1775 To 1783

 

Name

Highest Responsibility

Education/Experience

 

Benjamin Church
John Morgan
William Shippen, Jr.

John Cochran

Benjamin Rush
Malachi Treat

Ammi R. Cutter
William Brown
Walter Jones

Charles McKnight

Philip Turner

Jonathan Potts

Samuel Stringer
James Craik

Peter Dott Fayssoux

Hugh Williamson
Bodo Otto

James Tilton

 

Director General
Director General

Director General

Director General

Physician General
Physician General,

Chief Hospital Physician
Physician General

Physician General
Physician General
Surgeon General,

Chief Hospital Physician
Surgeon General

Deputy Director General

Director of Hospital in North

Chief Physician and Surgeon
General of the Army

Chief Physician and Surgeon
General of Southern
Department

Surgeon to the North Carolina

militia
In charge of Yellow Springs
hospital

In charge of various hospitals,

including that at Trenton

Studied medicine in London

M.D. from Edinburgh, further medical
studies in England and Europe,
surgeon in French and Indian War

M.D. from Edinburgh, further medical
studies in England

Apprentice-trained in England, sur-
geon’s mate in French and Indian
War

M.D. from Edinburgh

Professor of Medicine at King’s Col-
lege

Served with British at Louisburg and
in Indian frontier wars with rangers

M.D. from Edinburgh

M.D. from Edinburgh

Private student of William Shippen, Jr.

Assistant surgeon to provincial regi-
ment under General Amherst at
Ticonderoga

Studied medicine at Edinburgh, M.D.
from Philadelphia

Served in British Army

Trained at Edinburgh, served
French and Indian War

Medical education at Edinburgh

in

Medical education at Edinburgh and
London, M.D. from Utrecht
Medical education in Europe

Graduate of Philadelphia

 

 

Sources: Gordon, Aesculapius, pp. 42, 47, 95, 127, 216, 304, 369, 374, 417, 476; Major, History
of Medicine, 2: 718, 721-22; Butterfield, Letters of Rush, 1: 108n, 163n, 177n; Sydney H. Carney,

Jr., “Some Medical Men in the Revolution,” Magazine of History 21 (1915):

185; Duncan,

Medical Men, p. 84; Brown, Medical Department, pp. 40, 41, 42, 43, 44, 47, 60.
200

APPENDIX B
Law oF 27 JuLy 1775

The Congress took into consideration the
report of the committee on establishing an
hospital, and the same being debated, was
agreed to as follows:

That for the establishment of an hospital
for an army consisting of 20,000 men the fol-
lowing officers and other attendants be ap-
pointed, with the following allowance or pay,
viz.

1 Director general and chief physician,

his pay per day 4 dollars

4 Surgeons, per diem, each 1 1/3 do.
1 Apothecary 1 1/3 do.

20 Mates, each 2/3 do.
1 Clerk 2/3 do.

2 Storekeepers, each 4 dollars per
month

1 Nurse to every 10 sick, 1/15 of a dollar
per day, or 2 dollars per month

Labourers occasionally.

The duty of the above officers: viz.

Director to furnish medicines, Bedding and
all other necessaries, to pay for the same,
superintend the whole, and make his report
to, and receive orders from the commander in
chief.

Surgeons, apothecary and mates: To visit
and attend the sick and the mates to. obey
the orders of the physicians, surgeons and
apothecary.

Matron: To superintend the nurses, bedding,
etc.

Nurses: To attend the sick, and obey the
matron’s orders.

Clerk: To keep accounts for the director
and storekeepers.

Storekeeper: To receive and deliver the bed-
ding and other necessaries by order of the
director . . . .

The Congress then proceeded to the choice
of officers for the Hospital, when

Benjamin Church was unanimously elected
as director of, and chief physician in, the
hospital.

Resolved, That the appointment of the four
Surgeons and the Apothecary be left to Doctr.
Church.

That the Mates be appointed by the Sur-
geons; that the number do not exceed twenty;

THE ARMY MEDICAL DEPARTMENT,

1775-1818

that the number be not kept in constant pay,
unless the sick and wounded should be so
numerous as to require the attendance of twen-
ty, and to be diminished as circumstances will
admit; for wch. purpose, the pay is fixed by
the day, that they may only receive pay for
actual service.

That one Clerk and two storekeepers and
one nurse to every 10 sick be appointed by
the Director.

Source: Ford, Journals of the Continental Con-
gress, 2: 209-10, 211.

APPENDIX C
Law ofF 17 JuLy 1776

The Congress took into consideration the
report of the Committee on the memorial of
the director general of the American hospital;
Whereupon,

Resolved, That the number of hospital sur-
geons and mates be increased, in proportion to
the augmentation of the army, not exceeding
one surgeon and five mates to every five
thousand men, to be reduced when the army
is reduced, or when there is no further occasion
for such a number:

That as many persons be employed in the
several hospitals, in the quality of store keepers,
stewards, managers, and nurses, as are neces-
sary for the good of the service, for the time
being, to be appointed by the directors of the
respective hospitals:

That the regimental chests of medicines, and
chirurgical instruments, which are now, or
hereafter shall be, in the possession of the
regimental surgeons, be subject to the inspec-
tion and inquiry of the respective directors
of hospitals, and the director general; and that
the said regimental surgeons shall, from time
to time, when thereto required, render account
of the said medicines and instruments to the
said directors, or if there be no director in any
particular department, to the director general;
the said accounts to be transmitted to the
director general, and by him to this Congress;
and the medicines and instruments not used by
any regimental surgeon to be returned when the
regiment is reduced, to the respective directors,
and an account thereof rendered to the direc-
tor general and by him to this Congress:

That the several directors of hospitals, in
Appendix D

the several departments, and the regimental
surgeons, where there is no director, shall
transmit to the director general regular returns
of the number of surgeons’ mates and other
officers employed under them, their name and
pay; also an account of the expenses and
furniture of the hospital under their direction;
and that the director general make a report
of the same, from time to time, to the com-
mander in chief and to this Congress.

That the several regimental and hospital
surgeons, in the several departments, make
weekly returns of the sick to the respective
directors in their departments:

That no regimental surgeon be allowed to
draw upon the hospital of his department, for
any stores except medicines and instruments:
and that, when any sick person shall require
other stores, they shall be received into said
hospital, and the rations of the said sick
persons be stopped, so long as they are in
said hospitals, and that the directors of the
several hospitals report to the commissary the
names of the sick, when received into, and
when discharged from the hospitals, and make
a like return to the Board of Treasury:

That all extra expences for bandages, old
linen, and other articles necessary for the serv-
ice, incurred by any regimental surgeon, be
paid by the director of that department, with
the approbation of the commander thereof:

That no more medicines belonging to the
continent be disposed of, till further order of
Congress:

That the pay of the hospital surgeons be
increased to one dollar and two thirds of a
dollar by the day; the pay of the hospital mates
to one dollar by the day; and the pay of the
hospital apothecary to one dollar and two-
thirds of a dollar by the day; and that the
hospital surgeons and mates take rank of regi-
mental surgeons and mates:

That the director general, and the several
directors of hospitals, be empowered to pur-
chase, with the approbation of the commanders
of the respective departments, medicines and
instruments for the use of their respective
hospitals, and draw upon the paymaster for
the same, and make the report of such pur-
chases to Congress.

Source: Ford, Journals of the Continental Con-
gress, 5: 568-71.

201

APPENDIX D
Law oF 7-8 APRIL 1777

Resolved, That there be one director gen-
eral of all the military hospitals which shall
be erected for the continental army in the
United States, who shall particularly super-
intend all the hospitals between Hudson and
Potowmack rivers:

That there be one deputy director general,
who, in the absence of the director general,
shall superintend the hospitals to the eastward
of Hudson's river:

That there be one deputy director general,
who, in the absence of the director general,
shall superintend the hospitals in the northern
department:

That when the circumstances of the war
shall require it, there be one deputy director
general, who in the absence of the director
general, shall superintend the hospitals in the
southern department:

That the director general, or, in his ab-
sence, the deputy director general in each
respective department, be empowered and re-
quired, with the advice and consent of the
commander in chief therein, to establish and
regulate a sufficient number of hospitals, at
proper places, for the reception of the sick
and wounded of the army, to provide medi-
cines, instruments, dressings, bedding, and
other necessary furniture, proper diet, and
every thing requisite for the sick and wounded
soldiers, and the officers of the hospitals; to
pay the salaries and all other expences of the
same:

That there be assistant deputy directors, to
superintend the hospitals committed to their
care, and assist in providing the articles before
specified, under the orders and controul of the
director or deputy director general of the
respective districts:

That there be one apothecary general for
each district, whose duty it shall be, to receive,
prepare, and deliver medicines, and other
articles of his department to the hospitals and
army, as shall be ordered by the director gen-
eral, or deputy directors general, respectively:

That the apothecaries [general] be allowed
as many mates as the director general, or
respective deputy director generals, shall think
necessary:
202

That there be a commissary of the hospitals
in each of the aforesaid districts, whose duty
it shall be, to procure, store, and deliver pro-
visions, forage, and such other articles as the
director, or deputy director general shall judge
necessary for the use of the hospitals; in the
purchase of which, he shall frequently consult
with the commissary and quarter master gen-
eral, and be regulated by the prices which
they give:

That the commissary be allowed such as-
sistants and store keepers, as the director
general, or deputy director general of the
district, shall judge necessary:

That a steward be allowed for every hun-
dred sick or wounded, who shall receive pro-
visions from the commissary, and distribute
them agreeable to the orders of the director
general, or in his absence, of the deputy di-
rector general, or physician, or surgeon general,
and be accountable to the commissary for the
same:

That a matron be allowed to every hundred
sick or wounded, who shall take care that the
provisions are properly prepared; that the
wards, beds, and utensils be kept in neat order,
and that the most exact oeconomy be observed
in her department:

That a nurse be allowed for every ten sick
or wounded, who shall be under the direction
of the matron:

That an hostler or stabler be allowed to
each hospital, to receive the horses from the
commissary, and to take care of the waggon,
and other horses belonging to the hospital,
pursuant to orders from the director general,
or, in his absence, the deputy director general,
or such other officer as he shall appoint:

That there be a clerk in each district, whose
business it shall be, to keep the accounts of
the hospitals, and to receive and deliver the
monies agreeable to the orders of the director
or deputy director general:

That a sufficient number of assistant clerks
be allowed:

That such officers and soldiers as the gen-
eral shall order to guard the hospitals and to
conduct such as shall be weekly discharged
the hospitals, to their respective regiments,
shall, while on this duty, obey the director or
deputy director general, or the physicians and
surgeons general;

THE ARMY MEDICAL DEPARTMENT,

1775-1818

That the director and deputy directors gen-
eral be respectively empowered to appoint
and discharge their assistant deputy directors,
and other said officers and attendants of the
hospitals, in such numbers as the necessities
of the army may require, and the commander
in chief of the department shall, in writing,
approve; report of which to be immediately
made to Congress, as hereafter directed:

That there be also one physician and one
surgeon general in each district, to be ap-
pointed by Congress, whose duty it shall be,
respectively, to superintend the practice of
physic and surgery in all the hospitals of the
district to which they shall be appointed, and,
in the absence of the director or deputy direc-
tor general, they shall have power to order the
physicians, surgeons, and other officers of the
several hospitals, to such duty as they shall
think proper, and shall report weekly to the
director general, or, in his absence, to the
deputy director general, or, in his absence, to
the assistant deputy director, the state and
number of the sick and wounded in the hos-
pitals, and the delinquent officers of the same,
and see that such, as may be fit, shall be de-
livered every week to the officer of the guard,
to be conducted to the army:

That there be allowed, also, senior physi-
cians and surgeons, who shall attend, pre-
scribe for, and operate upon, and see properly
treated, such sick and wounded, as shall be
allotted them by the director general, deputy
director general, or assistant director, or physi-
cian, or surgeon general; the number for the
district to be determined by the director or
deputy director general, and appointed by the
surgeon and physician general:

That there be also such a number of second
surgeons as the director or deputy director
general for the district shall judge necessary,
to assist the senior surgeons, and be under
the same direction, and to be appointed by
the physician and surgeon general as afore-
said:

That there be also such a number of mates
as the director general or deputy director gen-
eral of the district shall direct, who shall
assist the surgeons in the care of the wounded,
and see that the medicines are properly and
regularly administered, and appointed in the
Appendix D

manner before directed for senior and second
surgeons:

That a suitable number of covered and
other waggons, litters and other necessaries
for removing the sick and wounded, shall be
supplied by the quarter master or deputy
quarter master general, and in cases of their
deficiency, by the director or deputy director
general:

That there be one physician and surgeon
general for each separate army, who shall be
subject to the orders and controul of the
director general and deputy director general
of the district wherein he acts: That his duty
shall be, to superintend the regimental sur-
geons and their mates, and to see that they
do their duty, to hear all complaints against
the said regimental surgeons and mates, and
make report of them to the director general,
or, in his absence, to the deputy director, or,
in their absence, from the said army, to the
commanding officer thereof, that they may be
brought to trial by court martial for misbe-
havior; to receive from the director general
or deputy director general, a suitable number
of large strong tents, beds, bedding, medicines,
and hospital stores, for such sick and wounded
persons as cannot be removed to the general
hospital with safety, or may be rendered fit
for duty in a few days; and shall also see that
the sick and wounded, while under his care,
are properly attended, and dressed and con-
veyed, when able, to the general hospital, for
which last purpose he shall be supplied by the
director general, or deputy director, with a
proper number of convenient waggons and
drivers:

That each physician and surgeon general of
the armies shall appoint such a number of
surgeons, nurses, and orderly men, as the direc-
tor general or deputy director general shall
judge necessary for the more effectual care
and relief of the sick and wounded, under the
care of such physician and surgeon general
as provided in the last foregoing section; and
the said physician and surgeons general shall
have under them, in each army, a steward to
receive, and properly dispense such articles of
diet as the director general, or deputy director
general shall give, or order to be given him by
the commissary of the army or hospital:

That whenever any regimental surgeon or

203

mate shall be absent from his regiment without
leave from the said surgeon general, or the
commander in chief of the army where his
duty lies, the said surgeon general shall have
power to remove such surgeon or mate, and
forthwith to appoint another in his stead:

That the director, deputy directors, physi-
cians, and surgeons general, and all other of-
ficers before enumerated, shall be tried by a
court martial for any misbehaviour, or neglect
of duty, as the commander in chief of the
several armies shall direct:

That the physician and surgeon general of
each army, shall cause daily returns to be
made to him, of all the sick and wounded,
which have been removed to the hospitals,
all that remain in the hospital tents, all that
are become fit for duty, all that are conva-
lescent, and all who may have died, specifying
the particular maladies under which the sick
and wounded labour:

That the said physicians and surgeons gen-
eral shall cause weekly returns of the same to
be made to the director or deputy director
general respectively:

That the physicians and surgeons general
of the hospitals, cause like daily returns to be
made in every hospital, and the like weekly
returns to their respective directors, mutatis
mutandis:

That the deputy directors general cause the
like returns to be made, once every month,
to the director general, together with the names
and denominations of all the officers in the
respective hospitals.

And that the director general make a like
return for all the hospitals and armies of these
United States, once every month, to the
Medical Committee:

That the Medical Committee have power to
appoint any of their members to visit and in-
spect all or any of the medical departments,
as often as they shall think proper, to enquire
into the conduct of such general officers of
the hospital as shall be delinquent in this or
any parts of their duty, and to report their
names to Congress, with the evidence of the
charges, which shall be brought against
them. . ..

Resolved, That in time of action and on
any other emergency, when the regimental
surgeons are not sufficient in number to attend
204

properly to the sick and wounded, that cannot
be removed to the hospitals, the director, or
deputy director general of the district, be em-
powered and required, upon the request of
the physician and surgeon general of the army,
to send, from the hospitals under his care, to
the assistance of such sick and wounded, as
many physicians and surgeons as can possibly
be spared from the necessary business of the
hospitals.

That the director, deputy directors general,
assistant deputy directors, physicians and
surgeons general, be, and they are hereby
required and directed to employ such parts
of their time, as may conveniently be spared
from the duties before pointed out to them, in
visiting and prescribing for the sick and
wounded of the hospitals under their care.

That the establishment of the medical de-
partment be as follows:

1 director general, 6 dollars
a day and 9 rations
3 deputy directors 5 do. 6 do.
general,
Indeterminate assistant 3 do. 6 do.

deputy director,

4 physicians general 5 do. 6 do.
and 4 surgeons
general each,

1 to each army, 5 do. 6 do.
physician and
surgeon general of
the army,

Senior Surgeons, 4 do. 6 do.
Second Surgeons, 2 do. 4 do.
Surgeons’ mates, 1 1/3 do. 2 do.
Apothecaries general, 3 do. 6 do.
Mates, 1 1/3 do. 2 do.
Commissary, 2 do. 4 do.
Clerk, who is to be 2 do. 4 do.
pay master,
Assistant clerks, 2/3 do. 1 do.
Stewards, 1 do. 2 do.
Matron, 1/2 do. 1 do.
Nurses, 24-90 1 do.
Stabler, 1 do. 1 do.
Regimental surgeons, 2 do. 4 do.
Ditto, mates 1 1/3 do. 2 do.

Ordered, That the regulations respecting hos-
pitals be published.

Source: Ford, Journals of the Continental Con-
gress, 7: 231-37, 244-46.

THE ARMY MEDICAL DEPARTMENT,

1775-1818

APPENDIX E
Law oF 6 FEBRUARY 1778

Congress took into consideration the report
of the committee to whom the letters from
Dr. Shippen, Dr. Rush, and others were com-
mitted; and thereupon came to the following
resolutions:

For the better regulating the hospitals of
the United States,

Resolved, That there be a deputy director
general for the hospitals between Hudson and
Potomack rivers; and that the superintending
care of the director general be extended
equally over the hospitals in every district,
and that he be excused from the duty of pro-
viding supplies, when the deputy director gen-
eral shall be ready to enter upon the office:

That the several officers of the hospitals
shall cease to exercise such of their former
powers as are herein assigned to other officers
thereof:

That in the absence of the director general
from any district, the physician general and
surgeon general shall hereafter determine the
number of hospitals to be provided by the
deputy director general for the sick and
wounded, and shall superintend and control
the affairs of such hospitals:

That the director general shall consult with
the physician general and surgeon general in
each district, about the supplies necessary for
the hospitals, and shall give orders in writing
to the deputy director general thereof to pro-
vide the same; and, in the absence of the direc-
tor general, the physician general and surgeon
general shall issue such orders:

That each deputy director general shall
appoint one or more of the assistant deputy
directors, under him, to the sole business of
providing beds, furniture, utensils, hospital
cloathing, and such like articles; and shall ap-
point one or more to provide medicines, in-
struments, dressings, herbs, and necessaries
of a similar kind:

That the director general shall frequently
visit the hospitals in each district, and see that
the regulations are carried into effect; shall
examine into the number and qualifications of
the hospital officers, report to Congress any
abuses that may have taken place, and dis-
charge the supernumerary officers, if there be
Appendix F

any, that all unnecessary expence may be saved
to the public; and when the director general
is in any particular district, the physician gen-
eral and surgeon general in that district shall
not appoint any officers without his consent:

That, on the settlement of hospital accounts,
the officers entrusted with public money shall
produce vouchers to prove the expenditure,
and receipts from the proper officers of the
hospitals, specifying the delivery of the stores
and other articles purchased; and the apothe-
caries, mates, stewards, matrons, and other
officers, receiving such stores and other articles,
shall be accountable for the same, and shall
produce vouchers for the delivery thereof from
such officers, and according to such forms as
the physicians general and surgeons general
have directed, or shall, from time to time,
direct; which forms and directions the physi-
cians and surgeons general shall report to the
Board of Treasury:

That the director general, or, in his absence
from the district, the physician general, and
surgeon general, shall appoint a ward master
for each hospital, to receive the arms, ac-
coutrements and cloathing of each soldier ad-
mitted therein, keeping entries of, and giving
receipts for such articles, which, on the re-
covery of the soldier, shall be returned to
him, or, in case of his death, the arms and
accoutrements shall be delivered to the com-
missary or deputy commissary of military
stores, and receipts be taken for the same;
and the ward master shall receive and be ac-
countable for the hospital cloathing; and per-
form such other services as the physician
general or the surgeon general shall direct:

That the physicians general and surgeons
general shall hereafter make no returns to the
deputy directors general, but the returns shall
be made by the said officers respectively to
the director general, who shall carefully trans-
mit copies of each with his monthly return
to Congress, and suspend such of the officers
aforesaid as neglect this or any other part of
their duty, and shall report their names to
Congress:

That the director and deputy directors gen-
eral forthwith prepare their accounts, and
adjust them with the commissioners of claims,
at the Board of Treasury.

That four dollars a day, and the former

205

allowance of rations, be hereafter allowed to
each assistant deputy director and the com-
missary of the hospitals in each district; and
one dollar a day, and two rations, to each
ward master:

Resolved, That Dr. Potts be called from the
northern district, and appointed to act as
deputy director general in the middle district.

Resolved, That the eldest assistant deputy
director in the northern district shall execute
the office of the deputy director general in
the said district, until the further orders of
Congress:

That the salaries of the hospital officers and
debts contracted for the hospitals of the
middle district to the time of Dr. Potts’s enter-
ing upon the office of deputy director general
therein, shall be adjusted and paid by the
director general, who shall deliver all the pub-
lic stores in his possession to the deputy direc-
tor general or his order, taking duplicate re-
ceipts for the same, and transmitting one of
each to the Board of Treasury; and the same
rule shall be observed by Dr. Potts with
respect to the salaries and debts of the hos-
pitals of the northern district, and the public
stores thereof, which are to be delivered to
his successor in office in that district.

Source: Ford, Journals of the Continental Con-
gress, 10: 128-31.

APPENDIX F
Law oF 30 SEPTEMBER 1780

Whereas, the late regulations for conducting
the affairs of the general hospital are in many
respects defective; and it is necessary that the
same be revised and amended, in order that
the sick and wounded may be properly pro-
vided for and attended, and the business of
the hospitals conducted with regularity and
oeconomy; therefore,

Resolved, That there be one director of the
military hospitals, who shall have the general
direction and superintendance of all the hos-
pitals to the northward of North Carolina;
that, within the aforesaid limits, there be
three chief hospital physicians, who shall also
be surgeons; one chief physician, who shall
also be a surgeon, to each seperate army;
fifteen hospital physicians, who shall also be
surgeons; twenty surgeons mates for the hos-
pitals; one purveyor, with one assistant; one
206

apothecary; one assistant apothecary; and to
each hospital a steward, matron, orderly men
and nurses, as heretofore:

That the director, or, in his absence, one of
the chief hospital physicians, be empowered
and required, with the advice and consent of
the Commander in Chief, or commander of
a seperate army, to establish and regulate such
a number of hospitals, at proper places, for
the reception of the sick and wounded of the
army, as may be found necessary:

That the director be authorised and instruct-
ed to enjoin the several chief hospital physi-
cians, and other officers of the hospitals under
his superintendance, to attend at such posts or
stations as he may judge proper, and also to
attend and perform such duties, at any post
or place, as a change of the position of the
army, or other circumstances, may from time
to time make necessary, and shall be required
by the Commander in Chief; and that, in case
of any dispute concerning their seniority or
precedence, the director shall determine the
same in the first instance, the party supposing
himself aggrieved being at liberty to appeal
for redress to the Medical Committee.

That in time of action, and on any other
emergency, when the regimental surgeons are
not sufficient in number to attend properly to
the sick and wounded that cannot be removed
to the hospitals, the director, or, in his absence,
the nearest chief hospital physician, be em-
powered and required, upon request of the
chief physician and surgeon of the army, to
send from the hospitals under his care, to the
assistance of such sick and wounded, as many
surgeons as can possibly be spared from the
necessary business of the hospitals:

That the director, or, in his absence, two
of the chief hospital physicians, shall make
out and deliver, from time to time, to the
purveyor, proper estimates of hospital stores,
medicines, instruments, dressings, and such
other articles as may be judged necessary for
the use of the hospitals; also direct the
apothecary or his assistant, to prepare and de-
liver medicines, instruments, dressings, and
other articles in his possession to the hospitals
and surgeons of the army and navy, as he or
they may judge necessary:

That the director authorise and instruct the
purveyor and apothecary to supply, for the

THE ARMY MEDICAL DEPARTMENT,

1775-1818

use of the regimental surgeons, such medi-
cines and refreshments as may be proper for
the relief of the sick and wounded, before
their removal to a general hospital, and to be
dispensed under the care, and at the direction
of the chief physician of the army:

That the director, or, in his absence, the
chief hospital physicians, respectively, be em-
powered occasionally to employ second mates,
when the number of the sick shall increase
so as to make it necessary, and to discharge
them as soon as the circumstances of the sick
will admit:

That the director, or, in his absence, the
chief hospital physicians, respectively, shall
appoint a ward master for each hospital, to
receive the spare regimental cloathing, arms,
and accoutrements of each soldier admitted
therein, keeping entries of and giving receipts
for every article received, which, when the
soldier shall be discharged, shall be accounted
for by the said ward master with the com-
manding officer of the regiment to which such
soldier belonged, or the officer directed to
take charge of the convalescents from the said
hospital; or, in case of the death of the
soldier, shall be accounted for with, and de-
livered to the quartermaster of the regiment
to which the said soldier belonged; and the
ward master shall receive and be accountable
for the hospital cloathing, and perform such
other services as the chief hospital physician
shall direct.

That the director shall make returns of all
the sick and wounded in the hospitals, once
every month, to the medical committee, to-
gether with the names and ranks of all the
officers and others employed in the several
hospitals:

That the director be required to employ
such part of his time as may be spared from
the duties before pointed out to him, in visit-
ing and prescribing for the sick and wounded
of the hospitals; and that he pay particular
attention to the conduct of the several officers
in the hospital department, and arrest, sus-
pend and bring to trial, all delinquents within
the same:

That the duty of the chief hospital physi-
cians shall be, to do and perform all the duties
herein before enjoined them to do in the ab-
sence of the director; to receive and obey
Appendix F

the orders of the director, made and delivered
to them in writing, to superintend the practice
of physick and surgery in the hospitals put
under their particular care by the director,
or which, by the order of the commander in
chief or the commander of a seperate army,
may be by them established; to see that the
hospital physicians and other officers attending
the same, do their duty; and make monthly
returns to the director, of the state and
number of the sick and wounded in the hos-
pitals under their care; and also make returns
to the director, and to the medical committee,
of all delinquent officers, in order that they
may be speedily removed or punished; and to
take measures that all such sick and wounded
as are recovered and fit for duty be delivered
weekly to the officer of the guard, to be con-
ducted to the army: when present at any
hospital, to issue orders to the proper officers
for supplying them with necessaries; and gen-
erally, in the absence of the director, to super-
intend and controul the business of such
hospitals, suspend delinquent and remove
unnecessary non-commissioned officers, mak-
ing report to the director; and, when in their
power, to attend and perform or direct all
capital operations:

That the hospital physicians shall take
charge of such particular hospitals as may
be assigned them by the director: They shall
obey the orders of the director, or in his
absence, of the chief hospital physician: They
shall have power to suspend officers under
them, and to confine other persons serving in
the hospitals under their charge, for negligence
or ill-behaviour, until the matter be regularly
inquired into: They shall diligently attend to
the cases of the sick and wounded of the
hospitals under their care, administering at all
times proper relief, as far as may be in
their power: They shall respectively give
orders, under their hands, to the assistant
purveyor or steward at the hospital, for the
issuing provisions and stores, as well as for the
procuring any other small articles that the
exigencies of the hospital may require, and
which the store is not provided with, having
always a strict regard to oeconomy, as well
as the welfare of the sick then to be provided
for: They shall make weekly returns to the
nearest chief hospital physician, of the state

207

of the hospitals under their respective care.

The mates shall each take charge of and
attend the patients assigned them and perform
such other duties as shall be directed by the
director, chief or other physicians and sur-
geons.

The chief physician and surgeon of the
army shall be subject to the orders and con-
troul of the director: His duty shall be to
superintend the regimental surgeons and their
mates, and to see that they do their duty: To
hear all complaints against the said regimental
surgeons and mates, and make report of them
to the director, or, in his absence, to the Com-
mander in Chief or commanding officer of a
seperate army, that they may be brought to
trial by court-martial for misbehaviour: To
draw for and receive from the purveyor a
suitable number of large strong tents, beds,
bedding and hospital stores, and from the
apothecary, or his assistant, proper medicines,
for such sick and wounded persons as cannot
be removed to the general hospital with safety,
or may be rendered fit for duty in a short
time. He shall also see that the sick and
wounded, while under his care, are properly
attended and provided for, and conveyed,
when fit to be removed, to the general hospital;
for which last purpose, he shall be supplied
by the quartermaster general, with a proper
number of convenient waggons and drivers;
he shall have a steward, which he is to ap-
point, to receive and properly dispense such
articles of diet and refreshment as shall be
procured for the sick; and also shall appoint
such a number of nurses and orderly men as
may be necessary for the attendance of the
sick and wounded under his care. He shall
cause daily returns to be made to him of all
the sick and wounded which have been re-
moved to the hospitals, all that remain in the
hospital tents, all that are become fit for duty,
all that are convalescent, and all who may have
died, specifying the particular maladies under
which the sick and wounded labour, and
shall make a monthly return thereof to the
director, who shall add it to his general hos-
pital returns, to be transmitted monthly to the
Medical Committee.

That whenever any regimental surgeon or
mate shall be absent from his regiment, with-
out leave from the chief physician and sur-
208

geon or commander of the army where his
duty lies, the said chief physician and sur-
geon shall have power to remove such surgeon
or mate and forthwith appoint another in his
stead.

That the purveyor provide, or cause to be
provided, all hospital stores, medicines, instru-
ments, dressings, utensils, and such other arti-
cles as shall be prescribed by the written
order of the director, or two of the chief
hospital physicians, and deliver, or cause the
same to be delivered, upon written orders,
under the hands of the director, or chief hos-
pital physician, or one of the hospital phy-
sicians, having the charge of a particular
hospital, or of a chief physician and surgeon
of the army, which, with receipts thereon for
delivery of the same, shall be his sufficient
vouchers. He shall be allowed a clerk, and as
many store keepers as occasion may require,
and the director shall approve of. He shall
also pay the salaries of the officers, and all
other expences of the hospitals. He shall ren-
der his accounts every three months to the
Board of Treasury for settlement, and make
application for money to the Medical Com-
mittee, before whom he shall lay estimates
of articles necessary, which shall previously
have been approved and signed by the director
or two of the chief hospital physicians; at the
same time he shall render to them an account
of the expenditure of the last sum of money
advanced to him; and the said Medical Com-
mittee shall lay such estimates before Congress,
with their opinion thereon:

That the assistant purveyor shall procure
such supplies, and do and perform such parts
of the purveyor’s duty, as by him shall be
particularly assigned to him.

That the apothecary and his assistant re-
ceive, prepare and deliver medicines, instru-
ments and dressings, and such other articles
of his department, to the hospitals and army,
on orders in writing from the director or
either of the chief hospital physicians, or chief
physician and surgeon of the army; and that
he be allowed as many mates as occasion may
require, and the director shall approve of:

That the director, or in his absence, the
chief hospital physician, shall appoint a stew-
ard for each hospital, whose duty it shall be to
purchase vegetables and other small articles,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

under the direction of the purveyor, and to
receive hospital stores from the purveyor, and
provisions from the commissary general, and
issue the same for the use of the sick and
wounded, agreeably to the order of the physi-
cian and surgeon attending such hospital; the
steward to account with the purveyor for all
such issues:

That the director, or, in his absence, the
chief hospital physician, appoint a proper
number of matrons, nurses, and others, neces-
sary for the regular management of the hos-
pitals, and fix and ascertain their pay, not
exceeding the sums heretofore allowed; and
point out and prescribe their particular duties
and employments, in writing, which they are
enjoined to observe and obey:

That the director, with two chief hospital
physicians, be empowered to fix the pay of
second mates, and of such clerks, store
keepers, and other persons, as may occasion-
ally be employed; and also make such regula-
tions, and point out and enjoin, in writing,
such further particular duties for the several
officers in the hospital department, as they
may judge necessary for the regular manage-
ment of the same; which duties shall always
be consistent with, and in no wise contradictory
to any of the duties herein before particularly
enumerated, and which being reported to, and
approved of by the Medical Committee, shall
thereupon become obligatory to all those con-
cerned:

That the quartermaster general furnish the
hospital department, from time to time, as
occasion may require, with such a number of
horses and wagons as may be necessary for
removing the sick and wounded, and for
transporting the hospital stores; but that no
other horses than those belonging to the of-
ficers of the department, for which forage may
be herein allowed, be kept seperately and at
the expence of the department.

That no person concerned in trade, on his
own account, shall be suffered to act as an
officer in the hospital or medical department of
the army:

That no officer or other person in the hos-
pital department, except the sick and wounded,
be permitted to use any of the stores pro-
vided for the sick:

That the director, chief hospital physicians,
Appendix F

and the chief physicians and surgeons of the
army, physicians and surgeons, purveyor,
apothecary, assistant purveyor, and assistant
apothecary, be appointed and commissioned
by Congress; the regimental surgeons and
mates to be appointed as heretofore:

That the director, with the advice and
concurrence of two of the chief hospital
physicians, appoint all hospital mates, which
appointments shall be certified by warrants
under the hand of the director; in which ap-
pointments no person shall be admitted under
the age of twenty-one years:

That all the officers in the hospital or
medical departments, shall be subjected to
trial by courts-martial for all offences, in the
same manner as officers of the line of the
army.

Resolved, That the pay and establishment
of the officers of the hospital department, and
medical staff, be as follows:

Director, one hundred and fifty dollars per
month, two rations for himself, and one for
his servant, per day, and forage for two
horses:

Chief physicians and surgeons of the army
and hospitals, each, one hundred and forty
dollars per month, two rations per day, and
forage for two horses:

Purveyor and apothecary, each, one hundred
and thirty dollars per month:

Physicians and surgeons of the hospitals,
each, one hundred and twenty dollars per
month, one ration per day, and forage for one
horse:

Assistant purveyors and apothecaries, each,
seventy-five dollars per month:

Regimental surgeons, each, sixty-five dollars
per month, one ration per day, and forage for
one horse:

Surgeons’ mates in the hospitals, fifty dol-
lars per month, one ration per day:

Surgeons’ mates in the army, forty-five dol-
lars per month, one ration per day:

Steward for each hospital, thirty-five dollars
per month, one ration per day:

Ward master for each hospital, twenty-five
dollars per month, one ration per day.

Resolved, That none of the aforesaid of-
ficers, or other persons employed in any of the
hospitals, be entitled to rations of provisions
or forage when on furlough.

209

Resolved, That the chief physician of the
army be allowed a two horse covered waggon
for transporting his baggage:

That the several officers abovementioned
shall receive their pay in the new currency,
emitted pursuant to a resolution of Congress
of the 18th day of March last; and that they
be allowed and paid at the rate of five dollars
of said currency per month for every retained
ration; and shall each be entitled annually to
draw cloathing from the stores of the cloathier
general, in the same manner and under the
same regulations as are established for officers
of the line, by a resolution of Congress of the
25th November, 1779:

That the returns for cloathing for officers
in the medical staff (regimental surgeons and
their mates, who are to draw with the regi-
mental staff, excepted) be signed by the direc-
tors, or one of the chief hospital physicians;
and such cloathing shall be delivered either
by the cloathier general or any sub-cloathier
in the state in which the officer to receive
cloathing shall reside, in the same manner as
is provided in the cases of other staff officers
not taken from the line:

That the several officers whose pay is estab-
lished as above (except the stewards and
ward masters) shall at the end of the war
be entitled to a certain provision of land. in
the proportion following, viz.

The director to have the same quantity as
a brigadier-general;

Chief physicians and purveyor, the same as
a colonel;

Physicians and surgeons and apothecary, the
same as a lieutenant colonel;

Regimental surgeons and assistants to the
purveyor and apothecary, the same as a major;

Hospital and regimental surgeons’ mates, the
same as a captain;

That the former arrangements of the hospital
department, and all resolutions heretofore
passed touching the same, so far as they
are inconsistent with the foregoing, be re-
pealed, excepting that the hospitals in the
southern department, from North Carolina to
Georgia, inclusive, be continued under the
same regulations as heretofore, until the
further order of Congress.

Source: Ford, Journals of the Continental Con-
gress, 18: 878-88.
210

APPENDIX G
HosPiTALS SERVING
WASHINGTON’S ARMY

In the period covered by Chapter 4, a large
number of hospitals served General Wash-
ington’s army. Among those not discussed in
the text are the following: !

Buckingham Meeting House, Pennsylvania.
On 15 November 1777, General Washington
ordered the sick of his army to be sent here,
but on 18 November the government of the
state of Pennsylvania apparently ordered that
no more sick be sent to that town. As of 24
November, the Buckingham unit contained
259 patients, 10 of these being wounded and
another 10 convalescent. This unit was among
those closed after the British occupation of
Philadelphia.

French Creek, Pennsylvania. The hospital
here was established in the winter of 1777-78
in the Lutheran Zion and German Reformed
churches as well as in the parsonage they
shared a few miles north of Yellow Springs.
III will was stirred up by the arbitrary manner
in which the buildings were requisitioned, but
when he arrived at nearby Yellow Springs,
Dr. Bodo Otto was able to smooth the matter
over. The facility was still in operation in
the spring of 1778, and the various com-
ponents, one of which held more than 60
patients and another almost 100, were de-
scribed at that time as “clean” and “airy.” ?

Lancaster, Pennsylvania. This facility seems
to have been established sometime in the fall
of 1777 and was the final destination of Brig.
Gen. Anthony Wayne's wounded after the
Paoli engagement. On 11 October 1777, the
unit held 59 patients. It was apparently suffer-
ing the effects of overcrowding in late January
and by early February was said to be caring
for as many as 400 to 500 patients. On 26
April 1778, Brig. Gen. Lachlan McIntosh re-
ported that 203 patients were in the hospital
there, 98 had died or deserted, and 340 had
been discharged since 1 January 1778. He
added to his report the fact that among the
latter there may have been some of the pa-
tients sent to Lancaster from Lititz.?

Limerick, Pennsylvania. A letter of Dr. Ben-
jamin Rush to John Adams of 13 October
1777 mentions a hospital located here, 26

THE ARMY MEDICAL DEPARTMENT,

1775-1818
miles from Philadelphia, on the road to Read-
ing.*
Manheim, Pennsylvania. A Manheim

church was apparently used as a hospital and
at least some medical supplies were stored in
the town until March, when Shippen ordered
them to be moved to Yellow Springs. Shippen
reported 62 patients in this hospital on 24
November 1777, of whom 17 were sick, 5
wounded, and 40 convalescent.’

North Wales, Pennsylvania. Mention is made
in at least one contemporary account of a
hospital established in a Quaker meeting-
house on the North Wales road. Shippen re-
ported on 24 November 1777 that there were
in this unit 100 sick and 59 convalescents.®

Phoenixville, Pennsylvania. William Shain-
line Middleton, in his article “Medicine at Val-
ley Forge,” mentions a hospital located in a
German Reformed church near Phoenixville
in the spring of 1778.7

Plumstead (Plumsteadbville), Pennsylvania. A
report dated 10 December 1777 lists a hos-
pital here which admitted 40 patients at the
end of November, of whom by 10 December
2 had died and 10 had been discharged, leav-
ing 28 remaining. On 19 December 1777, the
patients remaining here were removed by Gen-
eral Washington’s orders, escorted by a sur-
geon, to Lititz.®

Red Lion (Red Lyon, Lionville), Pennsyl-
vania. The Uwchlan Quaker Meeting House
here was taken over by force to be used as a
hospital in the winter of 1778. A hospital was
still in existence at Red Lion in June 1778
and was sheltering 127 patients as of 14 June
1778.9

Reamstown (Rheimstown), Pennsylvania.
This unit was opened in December 1777 and
closed on 17 March 1778. From 21 January
to 17 March, 19 Reamstown patients either
died or deserted.'®

Schaefferstown, Pennsylvania. This unit must
have been established at essentially the same
time as those at Ephrata and the other towns
in the same general area. General Mclntosh’s
report on Schaefferstown covers the period 1
January 1778 to 19 April 1778 and lists 76
patients remaining as of the latter date, 7
having died or deserted in the period and
103 returned to duty.'!

Warwick (Warrick), Pennsylvania. At least
Appendix H

some of the patients at this hospital were lo-
cated in a Lutheran church, but General Mc-
Intosh’s report of 26 April speaks of “Three
Churches, Warwick.” The unit was closed 7
April 1778 and its remaining two patients
went to Manheim. Of the men cared for here,
41 were reported dead or deserted, 142 re-
turned to camp.!?

York(town), Pennsylvania. Although in late
March the hospital here was reported as shel-
tering few patients, General McIntosh re-
ported 23 still in this facility as of 27 April
1778 and the journal of the Rev. Dr. James
Sproat implies that this facility was still open
on 9 June 1778.12

Black River, New Jersey. A hospital existed
here for at least part of the spring and sum-
mer of 1777. In June, General Washington
urged the replacement of the male nurses
here by women, although there is no record
of whether this was actually done.!*

Mendham, New Jersey. A hospital existed
here in a barn and a church near General
Washington's army at Morristown for at least
several months of the winter and spring of
1778. As in the case of Black River, New
Jersey, General Washington wished the male
nurses here to be replaced by women.s

Red Bank, New Jersey. Dr. Benjamin Rush
was assigned the task of opening a hospital
here to care for the wounded of the Delaware
River forts in November 1777. It is unlikely,
however, that he was able to progress far with
his task, because Fort Mifflin, across the river
from Fort Mercer, was abandoned by the
Americans the night of 15-16 November and
Fort Mercer five days later.1¢

APPENDIX H

AN ACT TO REGULATE THE
MEDICAL ESTABLISHMENT,
2 MARCH 1799

Sec. 1. Be it enacted by the Senate and
House of Representatives of the United States
of America in Congress assembled. That in the
medical establishment of the United States
there shall be the following officers: A physi-
cian-general, who shall be charged with the

211

superintendence and direction of all military
hospitals, and, generally, of all medical and
chirurgical practice or service concerning the
army and navy of the United States, and of all
persons who shall be employed in and about
the same, in camps, garrisons, and hospitals.
An apothecary-general, and one or more
deputies, who shall be charged with the safe
keeping and delivery of all medicines, instru-
ments, dressings, and other articles, for the use
of the hospital and army. A purveyor, who
shall be charged with providing medicines,
stores, and whatsoever else may be necessary
in relation to the said practice or service. A
competent number of hospital surgeons, who
shall be liable to serve in the field, and who
shall have the immediate charge and direction
of such military hospitals as may be committed
to their care, respectively. A suitable number
of hospital mates, who are to observe the
directions of the hospital surgeons, and shall
diligently perform all reasonable duties re-
quired of them for the recovery of the sick and
wounded.

Sec. 2. And be it further enacted, That each
military hospital shall have a steward, with a
competent number of nurses, and other attend-
ants; which steward shall be charged with the
procuring of such supplies as may not other-
wise be furnished, and with the safe keeping
and issuing of all supplies.

Sec. 3. And be it further enacted, That the
said physician-general, hospital-surgeons, pur-
veyor, and apothecary or apothecaries, deputy
or deputies, shall be appointed as other officers
of the United States; and the said mates and
stewards shall be appointed by the authority,
and at the direction, of the said physician-
general, subject to the eventual approbation and
control of the President of the United States,
and shall be removable by the authority of the
said physician-general; and that the surgeon of
each hospital shall appoint, employ and fix the
compensations of, the nurses and other attend-
ants of such hospital, subject to the control of
the said physician-general, or the hospital
surgeon, of senior appointment, with a separate
army, or in a separate district.

Sec. 4. And be it further enacted, That as
often as the regimental sick will not suffer by
the employing of regimental surgeons or mates
212

in the temporary or other hospitals of the
United States, the physician-general, or the
hospital surgeon, of senior appointment, with a
separate army, or in a separate district, with
the consent of the general and commander-in-
chief, or the officer commanding a separate
army, may require the attendance of such
surgeons, or surgeon’s mates, as in his opinion,
can be with safety so withdrawn from their
regiments.

Sec. 5. And be it further enacted, That it
shall be the duty of the physician-general, with
two or more hospital surgeons, to frame a
system of directions relative to the description
of patients to be admitted into the hospitals; to
the means of promoting cleanliness in the hos-
pitals; to the prevention of idleness, skulking,
and gambling, in the hospitals; to the prevention
of the spread of infectious distempers in the
camps and hospitals, and the government of
nurses, and all others charged with the care
of the sick in camps or hospitals, subject, in
the first instance, to the approbation and re-
vision of the commander-in-chief, the com-
mander of a separate army, or in a separate
district, as the case may be, and, eventually,
to the approbation and control of the President
of the United States: Provided always, That
the said directions, having received the sanc-
tion of the commander-in-chief, or the com-
mander of a separate army, shall be operative,
and remain in full force, unless altered or
annulled by the President of the United States.

Sec. 6. And be it further enacted, That the
compensations of the said several officers shall
be as follows: of the physician-general, one hun-
dred dollars pay per month, and fifty dollars
per month, which shall be in full compensation
for forage, rations, and travelling expenses: of
the purveyor, one hundred dollars pay per
month, in full compensation for his services,
and all expenses: of the apothecary general,
eighty dollars pay per month, and thirty dollars
per month, in full compensation for forage,
rations, and all expenses: of each of his
deputies, fifty dollars pay per month, and six-
teen dollars per month, in full compensation
for forage, rations and all expenses: of each
hospital surgeon, eighty dollars pay per month,
and forty dollars per month, in full compensa-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

tion for forage, rations, and all expenses: of
each mate, thirty dollars pay per month, and
twenty dollars per month, in full compensation
for forage, rations, and all expenses: of each
steward, twenty-five dollars pay per month,
and eight dollars per month, in full compensa-
tion for forage, rations, and all expenses:
Provided, That none of the officers aforesaid
shall be entitled to any part of the pay or
emoluments aforesaid, until they shall re-
spectively, be called into actual service.

Sec. 7. And be it further enacted, That, for
the accommodation of the sick of the army and
navy of the United States, the physician-
general, and hospital surgeon of senior appoint-
ment, with the approbation of the general
commanding the army within the district where
he shall be, shall have power to provide tem-
porary hospitals; and the physician-general,
with the approbation of the President of the
United States, shall have power to provide and
establish permanent hospitals.

Sec. 8. And be it further enacted, That all
the said officers, and others, shall, as touching
their several offices and duties, be liable to the
rules and regulations for the government and
discipline of the army and shall be bound to
obey, in conformity with law and the usages
and customs of armies, the orders and direc-
tions of the chief military officers of the respec-
tive armies, and within the respective districts
in which they shall respectively serve and be.

Sec. 9. And be it further enacted. That the
physician-general or, in his absence, the senior
medical officer, with the approbation of the
commander-in-chief, or commanding officer of
a separate army, be, and hereby is, authorized
and empowered, as often as may be judged
necessary, to call a medical board, which shall
consist of the three senior medical officers,
then present, whose duty it shall be to examine
all candidates for employment or promotion in
the hospital department, and certify to the
secretary of war the qualifications of each.

(Approved, March 2, 1799.)

SOURCE: Trueman Cross, Military Laws of the
United States; to Which is Prefixed the Constitu-
tion of the United States (Washington: Edward de
Krafft, 1825), pp. 96-99.
Appendix J

APPENDIX 1

LEGISLATION CONCERNING
THE U.S. ARMY MEDICAL
DEPARTMENT

March 1813: That, for the better superintend-
ence and management of the hospital and
medical establishment of the army of the
United States, there shall be a physician and
surgeon-general, with an annual salary of
$2500, and an apothecary-general, with an
annual salary of $1800; whose respective duties
and powers shall be prescribed by the President
of the United States.

[January-March 1814: legislation reaffirming
ratio of one surgeon and two mates per
regiment.]

March 1814: That, from and after the first day
of June next, the officers of the army shall be
entitled to waiters, agreeable to grade, as
follows: . . . the physician and surgeon general,
two; . . . hospital surgeon, each, one. . . .

That the President of the United States be
authorized to appoint so many assistant
apothecaries as the service may, in his judg-
ment, require; each of whom shall receive the
same pay and emoluments as a regimental
surgeon’s mate.

That the physician and the surgeon general
of the army be entitled to two rations per day,
and forage for two horses; and that in addition
to their pay, as at present established by law,
the regimental surgeons and regimental surg-
eons’ mates be entitled to $15 per month each.

Sources: Callan, Military Laws, pp. 246, 253-55;
William O. Owen, ed., 4 Chronological Arrange-
ment of Congressional Legislation Relating to the
Medical Corps of the United States Army From
1785 to 1917 (Chicago: American Medical Asso-
ciation, 1918), pp. 10-11.

APPENDIX J
DUTIES OF MEMBERS OF
THE MEDICAL DEPARTMENT,
1814

Physician and Surgeon General:

1) establish rules for management of Army
hospitals and see that they are enforced;

2) appoint stewards and nurses;

213

3) request and receive returns of medicines,
surgical instruments, hospital stores;

4) authorize, regulate supply of regimental
medicine chests;

5) report twice a year on regimental medi-
cine chests, sick in hospitals to War Depart-
ment;

6) report yearly to War Department on
estimated supply needs.

Apothecary General:

1) assist Physician and Surgeon General in
his duties;

2) obey orders of Physician and Surgeon
General.

Apothecary General and his assistants:

1) receive and manage all hospital stores,
medicines, surgical instruments, dressings,
bought by commissary general of purchases or
his deputies;

2) account to superintendant general of
military supplies for all disbursement of items
under 1) above;

3) pay monthly wages of stewards, ward
masters, nurses of hospital;

4) compound, prepare, and issue medicines
under direction of Physician and Surgeon Gen-
eral or on estimates and requisitions of senior
hospital surgeons and regimental surgeons;

5) regulate, under supervision of superin-
tendant general of military supplies, forms of
returns made quarterly to apothecary general's
office by deputy apothecaries, surgeons, mates,
or those having charge of instruments, medi-
cine, hospital stores, hospital equipment of any
kind.

Senior hospital surgeons:

1) direct medical staff in army or district
to which he is attached;

2) live at or near headquarters;

3) countersign all requisitions of regimental
surgeons or mates made on apothecary general
or his assistants;

4) inspect hospitals under him, correcting
abuses and reporting delinquencies;

5) make quarterly reports to Physician and
Surgeon General on sick and wounded in his
hospital and on medicines, instruments, hospital
stores received, expended, on hand, and
wanted;
214

6) keep diary of weather, medical top-
ography of country where he is serving;

7) report to commanding officer concerning
anything concerning the health of the troops.

Hospital surgeons:

1) superintend everything relating to hos-
pital;

2) order steward to furnish whatever is
needed by the sick;

3) visit sick and wounded in hospital every
morning;

4) require from resident mate report on all
changes since morning;

5) instruct mate in writing on care of
patients;

6) have police rules of hospital displayed in
each ward;

7) assign appropriate wards to patients;

8) keep register of all patients admitted;

9) keep case book of every important or
interesting case of disease and report on it
monthly.

Mates:

1) visit patients with surgeon, take note of
his prescriptions;

2) keep case book;

3) attend to carrying out of
prescriptions;

4) dress all wounds;

5) enforce discipline;

6) one mate, at least, to remain on call;

surgeon’s

7) responsible for medicines and instru-
ments.
Steward:

1) receive and take charge of all hospital
stores, furniture, utensils, under surgeon’s
direction;

2) keep accurate account of all issues;
3) responsible to Apothecary General or his
assistant.

Ward master: under steward’s direction:

1) receive arms, accoutrements, clothing of
every patient admitted;

2) have clothes immediately washed, num-
bered, labeled with name, regiment, company
of patient and properly stored;

3) responsible for cleanliness of wards and
patients;

THE ARMY MEDICAL DEPARTMENT,

1775-1818

4) call roll every morning and evening;

5) supervise handling of closestools, seeing
that they are cleaned at least three times a day
and always have proper quantity of water or
charcoal in them;

6) see that beds and bedding are properly
aired and exposed to sun, weather permitting;

7) see that straw in each bed sack changed
at least once a month;

8) see that each patient washed and has hair
combed every morning;

9) see that bed and bedding of patient who
has been discharged or has died is cleaned and
straw burned;

10) see that nurses and attendants are kind
and attentive to patients;

11) supervise all attendants.

Source: Paraphrased from Palmer, Historical

Register, 3: 7-9.

ArpPENDIX K
LEGISLATION AFFECTING THE
ARMY MEDICAL DEPARTMENT,
MARCH 1815 To APRIL 1818

March 1815: That there shall be . . . such
number of hospital surgeons and surgeon's
mates as the service may require, not exceeding
five surgeons and fifteen mates, with one
steward and one ward-master to each hospital.
[This act also reaffirmed the ratio of one
surgeon and two mates for each regiment.]

April 1816: . and that the apothecary-
general, as heretofore authorized, be allowed
two assistant apothecaries.

That the medical staff shall be so extended
that there shall be four hospital surgeons and
eight hospital surgeon’s mates, to each division,
with as many post surgeons as the service may
require, not exceeding twelve to each division;
who shall receive the same pay and emoluments
as hospital surgeon’s mates. . . .

. .. and that the garrison surgeons and mates
be hereafter considered as post surgeons.

April 1818: That so much of the act “fixing
the military peace establishment of the United
States,” passed the 3d of March 1815, as relates
to hospital stewards and ward-masters, and so
much of the “Act for organizing the general
Appendix K

staff, and making further provision for the
army of the United States,” passed April 24,
1816, as relates to hospital surgeons, hospital
surgeon’s mates, . . . be and the same is hereby
repealed.

That there shall be one surgeon-general, with
a salary of two thousand five hundred dollars

215

per annum, one assistant surgeon-general with
the emoluments of a hospital surgeon, . . . to
each division . . . and that the number of
post-surgeons be increased, not to exceed eight
to each division.

Sources: Owen, Legislation, pp. 10-11; Callan,
Military Laws, pp. 266, 273-76, 285.
Notes

CHAPTER 1

1. Unless otherwise indicated, this chapter is
based on these secondary sources: Erwin
Heinz Ackerknecht, 4 Short History of Medi-
cine (New York: Ronald Press Co., 1955);
Stanhope Bayne-Jones, The Evolution of Pre-
ventive Medicine in the United States Army,
1607-1939 (Washington: Government Print-
ing Office, 1968); John B. Beck, Medicine in
the American Colonies: An Historical Sketch
of the State of Medicine in the American
Colonies, From Their First Settlement to the
Period of the Revolution (orig. printed Al-
bany, N.Y., 1850: Albuquerque, N. Mex.:
Horn & Wallace Publishers, 1966); Whitfield
Jenks Bell, Jr., “Medical Practice in Colonial
America,” Bulletin of the History of Medi-
cine 31 (1957): 442-53: Fielding H. Garri-
son, History of Medicine (Philadelphia: W.
B. Saunders Co., 1914): Maurice B. Gordon,
Aesculapius Comes to the Colonies (Ventor,
N.J.: Ventor Publishers, 1949); L. S. King,
The Medical World of the Eighteenth Century
(Chicago: University of Chicago Press, 1958);
R. H. Major, 4 History of Medicine (Spring-
field, Ill.: Charles C Thomas, 1954); Richard
Harrison Shryock. The Development of Mod-
ern Medicine: An Interpretation of the Social
and Scientific Factors Involved (New York:
Alfred A. Knopf, 1947): Richard Harrison
Shryock, Eighteenth Century Medicine in
America (Worcester, Mass.: American Anti-
quarian Society, 1950); Richard Harrison
Shryock, Medicine and Society in America,
1660-1860 (Ithaca, N.Y.: Cornell University
Press, 1960): Richard Harrison Shryock.
“Public Relations of the Medical Profession
in Great Britain and the United States: 1600--
1870,” Annals of Medical History, n.s. 2
(1930): 308-39: Allen O. Whipple. The Evo-
lution of Surgery in the United States (Spring-
field, Ill.: Charles C Thomas, 1963).

Also consulted for the preceding paragraph
were: Michael Kraus, “American and Euro-

pean Medicine in the Eighteenth Century,”
Bulletin of the History of Medicine 8 (1940):
683-84; Lyman H. Butterfield, “Benjamin
Rush: A Pnysician As Seen in His Letters,”
Bulletin of the History of Medicine 20
(1946): 150; George W. Corner, ed., The
Autobiography of Benjamin Rush: His “Trav-
els Through Life” Together With His “Com-
monplace Book” for 1789-1813 (Princeton,
N.J.: Princeton University Press, 1948), p.
362.

2. Quoted in Joseph Carson, 4 History of
the Medical Department of the University of
Pennsylvania, From Its Foundation in 1765
(Philadelphia: Lindsay and Blakiston, 1869),
p. 85; Corner, Rush, pp. 81-82, 362-64; Ben-
jamin Waterhouse, The Rise, Progress, and
Present State of Medicine (Boston: Thomas
and John Fleet, 1792), pp. 15-16, 17; Samuel
Miller, A Brief Retrospect of the Eighteenth
Century, 2 vols. (New York: T. and J.
Swords, 1803), 1:264-66.

3. Quoted in Shryock, Eighteenth Century
Medicine, p. 17; O. H. Perry Pepper, “Benja-
min Rush’s Theories on Blood Letting After
One Hundred and Fifty Years,” Transactions
of the College of Physicians of Philadelphia,
4th ser. 14 (1946): 122, 123; Nathan Smith
Davis, History of Medical Education and In-
stitutions in the United States From the First
Settlement of the British Colonies to the Year
1850 (Chicago: S. C. Griggs & Co., 1851), p.
70; Corner. Rush, pp. 364-65.

4. Many authors, including Bayne-Jones,
erroneously refer to Pringle as Surgeon-
General. John Pringle, Observations on the
Diseases in the Army, in Camp and Garrison
(London: A. Millar, D. Wilson, and T. Payne,
1752), pp. 96-98, 101-2, quote from pp.
101-2; Robert Thomas, The Modern Prac-
tice of Physic, 3d American ed. (New York:
Collin & Co., 1815), p. 275; Charles-Edward
Amory Winslow, “The Colonial Era and the
First Years of the Republic (1607-1799)—
The Pestilence That Walketh in Darkness,” in
218

C.-E. A. Winslow, Wilson G. Smillie, James
A. Doull, and John E. Gordon, The History
of American Epidemiology, ed. Franklin H.
Top (St. Louis: C. V. Mosby Co., 1952), pp.
21-23; David Hosack, Observations on the
Laws Governing the Communication of Con-
tagious Diseases and the Means of Arresting
Their Progress (New York: Van Winkle and
Wiley, 1815), pp. 2, 31, 34, 41; Wilson G.
Smillie, Public Health: Its Promise for the
Future: A Chronicle of the Development of
Public Health in the United States, 1607-1914
(New York: Macmillan Co., 1955), p. 37;
Miller, Brief Retrospect, p. 273; John Pringle,
Six Discourses, Delivered by Sir John Pringle,
Bart. . . ., To Which Is Prefixed the Life of
the Author by Andrew Kippis, D. D. F. R. S.
and S. A. (London: W. Strahan and T. Cadell,
1783), p. xii.

5. D'Arcy Power, Selected Writings: 1877-
1930 (Oxford: Clarendon Press, 1931), pp.
4-5; Silas Weir Mitchell, The Early History
of Instrumental Precision in Medicine (New
Haven: Tuttle, Morehouse & Taylor, 1892),
pp. 15-16, 21-23; Logan Clendening, ed.,
Source Book of Medical History (New York:
Dover Publications, 1942), p. 306; Erwin
Heinz Ackerknecht, Malaria in the Upper
Mississippi Valley, 1760-1900 (Baltimore:
Johns Hopkins Press, 1945), pp. 7, 54; Smil-
lie, Public Health, pp. 50-51; Richard
Brocklesby, Oeconomical and Medical Ob-
servations, in Two Parts, From the Year
1758 to the Year 1763, Inclusive . . . (Lon-
don: T. Becket and P. A. De Hondt, 1764),
p. 212; Donald Monro, An Account of the
Diseases Which Were Most Frequent in the
British Military Hospitals in Germany, From
January 1761 to the Return of the Troops

to England in March 1763 . . . (London: A
Millar, D. Wilson, T. Durham, and T. Payne,
1764), p. 8.

6. Pringle, Observations, p. 95; James

Lind, An Essay on Diseases Incidental in
Europeans in Hot Climates . . . (London: T.
Becket & P. A. De Hondt, 1768), pp. 36-38;
Gerhard van Swieten, The Diseases Incident
to Armies, With the Method of Cure . . . To
Which Are Added: The Nature and Treatment
of Gunshot Wounds, By John Ranby, Esquire,
Surgeon General to the British Army . . .

THE ARMY MEDICAL DEPARTMENT,

1775-1818

(Philadelphia: R. Bell, 1776), p. 5; John
Ballard Blake, “Diseases and Medical Practice
in Colonial America,” in “Symposium on the
History of American Medicine,” International
Record of Medicine 171 (1958): 351-53;
Smillie, Public Health, p. 43; Monro, An Ac-
count, pp. 265-67; Reuben Friedman, “Sca-
bies in Colonial America,” Annals of Medical
History, 3d ser. 2 (1940): 401-2; Alfred
Hess, Scurvy, Past and Present (Philadelphia:
J. B. Lippincott Co., 1920), p. 3.

7. Blake, “Diseases,” p. 356: Smillie,
Public Health, pp. 35, 67; Mark F. Boyd,
“An Historical Sketch of the Prevalence of
Malaria in North America,” American Journal
of Tropical Medicine and Hygiene 21 (1941):
229; Richard Harrison Shryock, “Medical
Practice in the Old South,” South Atlantic
Quarterly 29 (1930): 160-61; A. W. Ratcliffe,
“The Historical Background of Malaria—a
Reconsideration,” Journal of the Indiana State
Medical Association 39 (1946): 339; Robert
Hamilton, Observations on the Marsh Remit-
tent Fever . . . (London: T. Gillet, 1801), p.
23; Thomas, Modern Practice, pp. 4-6.

8. Such authors as John Duffy, Philip Cash,
and Wyndham B. Blanton maintain that phy-
sicians at the time of the American Revolution
could not distinguish between the two diseases,
but Fielding H. Garrison and John B. Blake
have noted that the disease described as ‘“‘pu-
trid, malignant” fever may have been typhus
and “slow, nervous” fevers typhoid. Neil
Cantlie maintains that typhus was at this time
already beginning to be recognized “as a
specific entity,” but Lester S. King explains
that although Pringle described jail or hospital
fever so well that we can recognize it today as
typhus, the great British military physician
did not consider this illness to be a specific
entity but rather believed that any putrid dis-
ease could lead to what he called jail or hos-
pital fever. John Duffy, Epidemics in Colonial
America (Baton Rouge: Louisiana State
University Press, 1953), p. 232; Philip Cash,
Medical Men at the Siege of Boston, April
1775-April 1776 . . . (Philadelphia: Ameri-
can Philosophical Society, 1973), p. 53; Wynd-
ham Bolling Blanton, Medicine in Virginia in
the Eighteenth Century (Richmond: Garrett &
Massie, 1931), p. 258; Garrison, History of
Notes to Chapter 1

Medicine, pp. 292-93; Blake, “Diseases,”
p. 353; Neil Cantlie, A History of the Army
Medical Department, 2 vols. (Edinburgh:
Churchill Livingstone, 1974), 1: 57; King,
Medical World, pp. 136-37.

9. Quoted in Dufly, Epidemics, p. 232;
Brocklesby, Observations, p. 212; Medical De-
partment, United States Army, Infectious Dis-
eases, Internal Medicine in World War II,
vol. 2 (Washington: Government Printing Of-
fice, 1963), p. 217; Monro, An Account,
p. 8; Van Swieten, Diseases, p. 86.

10. Monro, An Account, pp. 57-58.

11. Van Swieten, Diseases, p. 68.

12. Monro, An Account, p. 57.

13. Van Swieten, Diseases, pp. 67-73,
quotes from p. 69; John Hunter, Observations
on the Diseases of the Army in Jamaica . . . ,
3d ed. (London: T. Payne, 1808), p. 176;
Thomas, Modern Practice, pp. 278-80; Smil-
lie, Public Health, p. 43.

14. John Hunter, A Treatise on the Ve-
nereal Disease, abridged by William Currie
(Philadelphia: Charles Cist, 1787), p. 59,
quote from p. 5; Howard Lewis Applegate,
“Remedial Medicine in the American Revolu-

tionary Army,” Military Medicine 126
(1961): 450; Smillie, Public Health, pp.
48-49.

15. Quoted in Brocklesby, Observations, pp.
286-97; Van Swieten, Diseases, p. 95; Thomas,
Modern Practice, p. 502.

16. Monro, An Account, p. 265.

17. Quoted in van Swieten, Diseases, p. 100;
Monro, An Account, pp. 266-67; Brocklesby,
Observations, pp. 285-86; Van Swieten, Dis-
eases, pp. 100-1; Ltr, Col Robert J. T. Joy,
MC, to author, 25 Mar 76.

18. Van Swieten, Diseases, pp. 14, 19-31,
quote from p. 28.

19. David Ramsay, A Review of the Im-
provements, Progress and State of Medicine
in the XVIIIth Century (Charleston: W. P.
Young, 1801), pp. 18-19; Lind, An Essay.
p. 233; John Hunter, Hunterian Reminiscences;
Being the Substance of a Course of Lectures
on the Principles and Practice of Surgery, De-
livered by the Late Mr. John Hunter, in the
Year 1785, ed. by J. W. K. Parkinson (Lon-
don: Sherwood, Gilbert, and Pepir, 1833),
p. 66; Corner, Rush, pp. 364-65; David Har-

219

ris, “Medicine in Colonial America,” Cali-
fornia and Western Medicine 51 (1939): 38.

20. Quoted in Beck, Medicine, p. 30: Francis
R. Packard, “How London and Edinburgh In-
fluenced Medicine in Philadelphia in the Eight-
eenth Century,” Annals of Medical History,
ns. 4 (1932): 227-28; Theodore Diller,
Franklin's Contribution to Medicine (Brook-
lyn, N.Y.: Albert T. Huntington, 1912),
pp. 9-10, 20, 25, 52, 56-57; William Pepper,
The Medical Side of Benjamin Franklin
(Philadelphia: William J. Campbell, 1911),
pp. 9-10, 12, 63, 72; William Buchan, Obser-
vations Concerning the Prevention and Cure
of the Venereal Disease . . (Dublin: P.
Wogan, J. Millikin, W. Sleater, J. Rice, P.
Moore, 1796), pp. 71-72; James Thacher,
American Medical Biography . . . (Boston:
Richardson & Lord and Cottons & Barnard,
1828), pp. 27-28; John Warren, A View of
the Mercurial Practice in Febrile Diseases (Bos-
ton: T. B. Wait and Co., 1813), pp. vi-viii,
1, 4; Ramsay, Review, pp. 16, 19: Miller,
Brief Retrospect, pp. 31-34.

21. Ramsay, Review, p. 19.

22. John Hunter, Treatise on the Blood, In-
flammation, and Gunshot Wounds (London:
John Richardson, 1794), p. 3.

23. Warren, Mercurial Practice, pp. 12-16.

24. Warren, Mercurial Practice, pp. 5, 7-8,
quote from p. 42; Thacher, Biography, pp. 27-
28; Buchan, Venereal Disease, pp. 68, 70.

25. Salvatore P. Lucia, A History of Wine
as Therapy (Philadelphia: J. B. Lippincott
Co., 1963), pp. 155-56; Brocklesby, Observa-
vations, pp. 195, 196, 223-24; Monro, An
Account, pp. 16, 17n; Thomas, Modern Prac-
tice, p. 47.

26. Ramsay, Review, pp. 18-19.

27. Hugues Ravaton, Chirurgie d'armée ou
traité des plaies d’armées a feu (Paris: Didot
le jeune, 1768), pp. 635-36.

28. Pringle, Observations, pp. 128, 131-32;
Monro, An Account, pp. 357-60; Albert A.
Gore, The Story of Our Services Under the
Crown. A Historical Sketch of the Army
Medical Staff (London: Bailliere, Tindall, and
Cox, 1879), p. 107; Cantlie, History, 1: 45,
145; Van Swieten, Diseases, p. 13.

29. Monro, An Account, pp. 357-59, 361-
64, 382-85, 403-6, quote from p. 395;
220

Brocklesby, Observations, pp. 27-28, 52-53;
Lind, An Essay, p. 165; Pringle, Observations,
pp. 131-32.

30. Ramsay, Review, p. 22, quote from
p. 23; Pringle, Observations, pp. 128-32, 133—
35; Lind, An Essay, p. 165; John Aiken,
Thoughts on Hospitals (London: Joseph John-
son, 1771), p. 20; Stephen Hales, A Treatise
on Ventilators (London: Manby, 1758),
pp. 1-3, 14; Thomas, Modern Practice,
pp. 283-84; Edward Cutbush, Observations
on the Means of Preserving the Health of
Soldiers and Sailors . . . (Philadelphia: Fry
and Kammerer, 1808), pp. 182-84, 190-91;
Robert P. Multhauf, 4 Catalogue of Instru-
ments and Models in the Possession of the
American Philosophical Society (Philadelphia:
American Philosophical Society, 1961), p. 32;
Monro, An Account, pp. 359-65, 368-69.

31. Monro, An Account, pp. 365-401,
quote from p. 400; Peter Middleton, 4 Medi-
cal Discourse, or an Historical Inquiry into
the Ancient and Present State of Medicine
... (New York: Hugh Gaine, 1769), p. 219.

32. John Jones, The Surgical Works of the
Late John Jones, M.D., 3d ed., edited by James
Mease (Philadelphia: Wrigley and Berriman,
1795), pp. 161-63, first quote from p. 157;
Monro, An Account, pp. 338-39, 344-45;
Cutbush, Observations, pp. 3-4, 55-57,
62-64; Van Swieten, Diseases, pp. 7, 9,
second quote from p. 9; General Committee
of Defense, Observations Relative to the Means
of Preserving Health in Armies, 7 Sep 1814;
Howard Lewis Applegate, “Preventive Medi-
cine in the American Revolutionary Army,”
Military Medicine 126 (1961): 379, 381.

33. Cutbush, Observations, pp. 12, 14-16;
Monro, An Account, pp. 317-18; Jones,
Works, pp. 158, 159; Pringle, Observations,
pp. 116-18; Applegate, “Preventive Medicine,”
p: 379.

34. Quoted in Jones, Works, p. 163; Apple-
gate, “Preventive Medicine,” pp. 380-81; Van
Swieten, Diseases, pp. 10-11; Pringle, Obser-
vations, p. 113; Ramsay, Review, p. 33; Cut-
bush, Observations, pp. 8-11.

35. Pringle, Observations, p.
Works, pp. 157, 170-71.

36. Cutbush became better known after he
joined the U.S. Navy as a surgeon in 1799.

112; Jones,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Jones, Works, pp. 168-69; Monro, An Ac-
count, p. 319; Cutbush, Observations, pp. 22—
23, 24-25, 26-27, 29, 32; Van Swieten,
Diseases, p. 8; Pringle, Observations, pp.
137-38.

37. Jones, Works, pp. 157, 167; Pringle,
Observations, pp. 105-9; William Buchan,
Observations Concerning the Diet of the Com-
mon People . . . (London: A. Steahan, T.
Cadell, Jr., and W. Davies, J. Balfour and
W. Creich, 1797), p. 7; Applegate, “Pre-
ventive Medicine,” pp. 379-80; Ramsay,
Review, pp. 31-33; Middleton, Medical Dis-
course, pp. 9-13; Monro, An Account, pp.
377-79; Cutbush, Observations, p. 38.

38. James Lind, A Treatise of the Scurvy
. . . (Edinburgh: Sands, Murray, and Cochran
for A. Kincaid & A. Donaldson, 1753),
pp. 192-95, 197-202, quotes from pp. 180,
181; Blake, “Diseases,” pp. 351-53; Hess,
Scurvy, p. 3; Van Swieten, Diseases, p. 7.

39. Van Swieten, Diseases, p. 90; William
Buchan, Domestic Medicine; or, the Family
Physician . . . , 2d American ed. (Philadel-
phia: Joseph Crukshank, 1774), p. 299; Miller,
Brief Retrospect, p. 289; Ramsay, Review,
pp. 28-30.

40. Lind, Scurvy, p. 182; Cutbush, Observa-
tions, pp. 30-31; Blanton, Medicine, p. 260.

41. John Morgan, A Recommendation of
Inoculation, According to Baron Dimsdale’s
Method (Boston: J. Gill, 1776), pp. 3, 7,
11-12, quote from p. 11; Cantlie, History,
1: 140, 281; Arnold C. Klebs, “The Historic
Evolution of Variolation,” Bulletin of the
Johns Hopkins Hospital 24 (1913): 71-72;
Reginald H. Fitz, “Zabdiel Boylston, Inocu-
lator, and the Epidemic of Smallpox in Boston
in 1721,” Bulletin of the Johns Hopkins Hos-
pital 22 (1911): 316-20; Winslow, “Colonial
Era,” pp. 19-20; John Ballard Blake, Public
Health in the Town of Boston, 1630-1822
(Cambridge: Harvard University Press, 1959),
pp. 112, 114; Thacher, Biography, p. 27;
Lyman H. Butterfield, ed., Letters of Benjamin
Rush: Memoirs of the American Philosophical
Society, 30, parts 1 and 2, 2 vols. (Princeton:
Princeton University Press, 1951), 1: 66-67;
Morris C. Leikind, “Vaccination in Europe,”
Ciba Symposia 3 (1942): 1101; Maurice B.
Gordon, “Medicine in Colonial New Jersey
Notes to Chapter 1

and Adjacent Areas,” Bulletin of the History
of Medicine 17 (1945): 45-47; Benjamin
Gale, “Historical Memoirs, Relating to the
Practice of Inoculation for the Smallpox, in
the British American Provinces, Particularly
in New England,” Royal Society of London,
Philosophical Transactions 55 (1765): 194-
95.

42. John Warren, A. Dexter, James Jack-
son, and John C. Warren, Report on Vaccina-
tion, n.p., 1 Jun 1808, pp. 136-38; U.S. War
Department, Subject Index, 1809-1860, Gen-
eral Orders, Adjutant General's Department,
Subject Index of the General Orders of the
War Department From 1 Jan. 1809 to 31
Dec. 1860, comp. under direction of Brig
Gen Richard C. Drum, by Jeremiah C. Allen
(Washington: Government Printing Office,
1886), p. 177; Bayne-Jones, Preventive Medi-
cine, p. 75; John B. Blake, Benjamin Water-
house and the Introduction of Vaccination, a
Reappraisal ~~ (Philadelphia: University of
Pennsylvania Press, 1957), p. 62; Anthony
Wayne, “General Wayne's Orderly Book,”
Michigan Pioneer and Historical Society 34
(1904): 350; Howard Dittrick, “Medical
Agents and Equipment Used in the Northwest
Territory,” in Jonathan Forman, comp., Phy-
sicians and the Indian Wars (Columbus, Ohio:
Ohio State Medical Association, 1953).

43. Quoted in Owsei Temkin, “The Role of
Surgery in the Rise of Modern Medical
Thought,” Bulletin of the History of Medi-
cine 25 (1951): 259.

44. Jones, Works, pp. 7-8, 111-13, quote
from p. 11; Power, Writings, p. 270; Harvey
Graham, The Story of Surgery (Garden City,
N.Y.: Doubleday, Doran & Co., 1939), p. 214;
Josiah Bartlett, A Dissertation on the Progress
of Medical Science in the Commonwealth of
Massachusetts (Boston: T. B. Wait and Co.,
1810), p. 15.

45. Ramsay, Review, pp. 10-11; Allen O.
Whipple, The Story of Wound Healing and
Wound Repair (Springfield, Ill.: Charles C
Thomas, 1963), p. 68; Jones, Works, pp. 10—
11, 33-34, 40-41; Benjamin Gooch, 4 Prac-
tical Treatise on Wounds and Other Chirurgi-
cal Subjects . . . , 2 vols. (Norwich: W. Chase,
1767), 1: 193; Henri Frangois Le Dran, The
Operations in Surgery of Mons. Le Dran,

221

trans. Thomas Gataker (London: C. Hitch
and R. Dodsby, 1749), p. 79; “The Medical
History of Louis XIV (Editorial),” Annals
of Medical History, 1st ser. 8 (1926): 203.

46. Hunter, Treatise on the Blood, pp. 207-
8; Jones, Works, pp. 36-38, 40-41; Hunter,
Reminiscences, p. 131; Lloyd Allan Wells,
“Aneurysm and Physiologic Surgery,” Bulletin
of the History of Medicine 44 (1970): 411-
24; Gooch, Treatise, 1: 102-3.

47. Jones, Works, p. 33.

48. Quote from John Ranby, “The Nature
and Treatment of Gunshot Wounds,” in van
Swieten, Diseases, p. 121; Hunter, Reminis-
cences, p. 65.

49. Ranby, “Gunshot Wounds,” in van
Swieten, Diseases, pp. 125, 126; Jones, Works,
p. 140.

50. Jones, Works, pp.
Swieten, Diseases, p. 94.

51. Jones, Works, pp. 16-17, quote from
p. 30; John S. Billings, “The History and
Literature of Surgery,” in Frederic Shepard
Dennis, ed., System of Surgery (Philadelphia:
Lea Brothers & Co., 1895), 1: 72. Billings has
termed the Petit tourniquet “an appliance of
almost as much importance as the ligature”;
Owen H. Wangensteen, Jacqueline Smith, and
Sarah D. Wangensteen, “Some Highlights in
the History of Amputation Reflecting Lessons
in Wound Healing,” Bulletin of the History of
Medicine 41 (1967): 101-2, 103; Miller,
Brief Retrospect, pp. 299-300; Samuel Clark
Harvey, The History of Hemostasis (New
York: Paul B. Hoeber, 1929), pp. 63-64;
Cantlie, History, 1: 59; Theodor Billroth, “His-
torical Studies on the Nature and Treatment of
Gunshot Wounds From the Fifteenth Century
to the Present Time,” trans. C. P. Rhoads,
Yale Journal of Biology and Medicine 4
(1931-1932): 235; Hunter, Treatise on the
Blood, pp. 209-10, 211; Gooch, Treatise, 1:
150-51, 154; Ramsay, Review, p. 11; Graham,
Surgery, p. 213. When the edges of a wound
have been brought together and held in this
position before the healing process has begun,
the wound is said to be healing by the first
intention.

52. Hunter, Treatise on the Blood, pp. 204,
211, quote from p. 204.

53. Wangensteen, “Amputation,” pp. 103,

141, 142; Van
222

105; Hunter, Reminiscences,
Jones, Works, pp. 21-22.

54. Jones, Works, pp. 19-20, quote from
p. 20; Hunter, Reminiscences, p. 69.

55. Hunter, Treatise on the Blood, pp. 496—
97, 499.

56. Quote from Gooch, Treatise, 1: 71;
Wangensteen, “Amputation,” p. 106.

57. Thomas, Modern Practice, pp. 332-33;
Benjamin Rush, Observations on the Cause
and Cure of the Tetanus (Philadelphia, 1787),
pp. 461-62.

58. Jones, Works, pp. 67, 134, 135-37;
Hunter, Treatise on the Blood, pp. 530, 532,
535-36; Hunter, Reminiscences, p. 104; Ram-
say, Review, p. 11; Ravaton, Chirurgie,
pp. 86-87.

59. Wangensteen, “Amputation,” pp. 105-6;
Louis C. Duncan, Medical Men in the Ameri-
can Revolution, 1775-1783, Army Medical
Bulletin No. 25 (Carlisle Barracks, Pa.: Med-
ical Field Service School, 1931), p. 11: C. M.
B. Gilman, “Military Surgery in the American
Revolution,” Journal of the Medical Society
of New Jersey 57 (1960): 493-94; Temkin,
“Surgery,” pp. 252-53; Buchan, Domestic
Medicine, p. 439; Miller, Brief Retrospect,
p. 301; Hunter, Reminiscences, p. 84; Jones,
Works, pp. 43-54, 59-60, 63-66, 70, 151,
154-55; Aiken. Thoughts, pp. 24-25.

60. Gooch, Treatise, 1: 78-79, 98-118;
Jones, Works. pp. 35, 63-66.

61. Temkin, “Surgery,” p. 251; Richard
Harrison Shryock, Medical Licensing in
America, 1650-1965 (Baltimore: Johns Hop-
kins Press, 1967), pp. 4-5, 8-9; Henry Wood-
house, ‘Colonial Medical Practice,” Ciba
Symposia 1 (1940): 383; Shryock, “Public
Relations,” pp. 310, 312; William Shainline
Middleton, “John Morgan, Father of Medical

pp. 79, 132;

Education in North America,” Annals of
Medical History, 1st ser. 9 (1927): 18;
Claude Edwin Heaton, “Medicine in New

York During the English Colonial Period,
1664-1775,” Bulletin of the History of Medi-
cine 17 (1945): 36-37: Duncan. Medical
Men, p. 38; Henry R. Viets, A Brief History
of Medicine in Massachusetts (New York:
Houghton Mifflin Co., 1930), p. 81.

62. William Frederick Norwood, Medical
Education in the United States Before the

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Civil War (Philadelphia: University of Penn-
sylvania Press, 1944), pp. 9, 58; R. H. Dalton,
“A Glance at the American Medical Profes-
sion Since the Beginning of the Present Cen-
tury,” Journal of the American Medical Asso-
ciation 21 (1893): 953; Winslow, “Colonial
Era,” pp. 18-19.

63. Whitfield Jenks Bell, Jr., “Philadelphia
Medical Students in Europe, 1750-1800,"
Pennsylvania Magazine of History and Biogra-
phy 67 (1943): 4; Norwood, Medical Educa-
tion, pp. 32-35.

64. Bell, “Students,” pp. 3, 13, 14, 18, 19;
Ramsay, Review, pp. 8, 9-10; Kraus, “Medi-
cine,” pp. 680-81; Edgar M. Bick, “French
Influences on Early American Medicine and
Surgery,” Journal of the Mount Sinai Hospital
24 (1957): 500, 502, 503; James Joseph
Walsh, History of Medicine in New York
.. ., 5 vols. (New York: National Americana
Society, 1919), 1: 40-41, 44; William Freder-
ick Norwood, “Medicine in the Era of the
American Revolution,” International Record of
Medicine 171 (1958): 395; Packard, “London
and Edinburgh,” p. 222; William Henry
Welch, “Influence of English Medicine Upon
American Medicine in Its Formative Period,”
in Papers and Addresses, ed. Walter C. Burket
(Baltimore: Johns Hopkins Press, 1920), 3:
445, 446, 447; Genevieve Miller, “Medical
Schools in the Colonies,” Ciba Symposia 8
(1947): 524; William Shainline Middleton,
“William Shippen, Junior,” Annals of Medical
History, n.s. 4 (1932): 442; Jones, Works,
pp. 4-8; James Gregory Mumford, 4 Nar-
rative of Medicine in America (Philadelphia:
J. B. Lippincott Co., 1903), p. 96.

65. Richard Harrison Shryock, American
Medical Research: Past and Present (New
York: Commonwealth Fund, 1947), p. 20;
Jules Calvin Ladenheim, “The Doctors’ Mob
of 1788,” Journal of the History of Medicine
5 (1950): 23, 24-25, 29-35; William Dosite
Postell, “Medical Education and Medical
Schools in Colonial America,” International
Record of Medicine 171 (1958): 366-67,
Norwood, Medical Education, pp. 6, 37, 38,
39, 42, 46; Walsh, Medicine in New York,
p. 47; D. J. D’Elia, “Dr. Benjamin Rush and
the American Medical Revolution,” Proceed-
ings of the American Philosophical Society
Notes to Chapter 2

110 (1966): 227; Nathan Smith Davis, Con-
tributions to the History of Medical Educa-
tion and Medical Institutions in the United
States of America 1776-1876 (Washington:
Government Printing Office, 1877), p. 12;
Richard Hingston Fox, Dr. John Fothergill
and His Friends, Chapters in Eighteenth Cen-
tury Life (London: Macmillan and Co.
1919), pp. 367-68.

66. John Morgan, “A Discourse Upon the
Institution of Medical Schools in America,” in
Publications of the Institute of the History of
Medicine (orig. printed in Philadelphia by Wil-
liam Bradford, 1765, reprinted facsimile from
first ed. with introduction by Abraham Flex-
ner; Baltimore: Johns Hopkins Press, 1937),
2: 16-17, 30-32; Norwood, Medical Educa-
tion, pp. 43-44, 67, 69-70.

67. Middleton, Medical Discourse, p. 68;
Butterfield, Letters of Rush, 1: 31n; Brooke
Hindle, The Pursuit of Science in Revolutionary
America, 1735-1789 (Chapel Hill: University
of North Carolina Press, 1956), pp. 61, 111-
12; Stephen Wickes, History of Medicine in
New Jersey, and of Its Medical Men From the
Settlement of the Province to A.D. 1800
(Newark: Dennis, 1879), p. 53; John D.
Comrie, History of Scottish Medicine, 2d ed.,
2 vols. (London: Bailliere, Tindall, & Cox,
1932), 2: 441; Bick, “French Influence,” pp.
508-9.

68. Davis, History of Medical Education,
pp. 20-21; Norwood, Medical Education, pp.
57, 58; Miller, “Medical Schools,” p. 523;
Duncan, Medical Men, pp. 17-18; Middleton,
“Morgan,” p. 14; James E. Gibson, Dr.
Bodo Otto and the Medical Background of
the American Revolution (Baltimore: Charles
C Thomas, 1937), pp. 48-49; Jones, Works,

pp. 11-12; Hindle, Science, p. 110; Corner,
Rush, p. 131.
69. Duncan, Medical Men, pp. 18-19;

Courtney Robert Hall, “The Beginnings of
American Military Medicine,” Annals of Medi-
cal History, 3d ser. 4 (1942): 122-23; Cantlie,
History, 1: 102, 145, 147; Gore, Story, pp. 94—
95, 104, 105; Pringle, Observations, pp. 131-
32; Monro, An Account, pp. 361-64; Lind,
An Essay, p. 165; Nicholas Senn, “The Evo-
lution of the Military Surgeon,” Surgery,
Gynecology and Obstetrics 8 (1909): 394;

223

Whitfield Jenks Bell, Jr., John Morgan, Conti-
nental Doctor (Philadelphia: University of
Pennsylvania Press, 1965), pp. 31-32, 42;
Billroth, “Gunshot Wounds,” pp. 239-40.

CHAPTER 2

1. Unless otherwise indicated, this chapter is
based on these secondary sources: P. M. Ash-
burn, A History of the Medical Department
of the United States Army (Boston: Houghton
Mifflin Co., 1929); Harvey E. Brown, The
Medical Department of the United States
Army From 1775 to 1873 (Washington: The
Surgeon General’s Office, 1873); Duncan,
Medical Men; Fielding H. Garrison, “Notes
on the History of Military Medicine,” re-
printed from Military Surgeon, vols. 49-51,
1921-22 (Washington: Association of Military
Surgeons, 1922); Gibson, Otto; Louis Clinton
Hatch, The Administration of the American
Revolutionary Army, Harvard Historical
Studies, vol. 10 (New York: Lenox Hill
Publ. & Dist. Co., 1904); Edgar Erskine
Hume, Victories of Army Medicine: Scientific
Accomplishments of the Medical Department
of the United States Army (Philadelphia: J.
B. Lippincott Co., 1943); James M. Phalen,
Chiefs of the Medical Department, United
States Army, 1775-1940, Army Medical Bul-
letin No. 52 (Carlisle Barracks, Pa.: Medical
Field Service School, April 1940); Erna
Risch, Quartermaster Support of the Army:
A History of the Corps, 1775-1939 (Wash-
ington: Government Printing Office, 1962);
Charles Smart, “Medical Department, U.S.
Army,” Journal of Military Service Institute
14 (May 1893): 692-708; Oliver Lyman
Spaulding, The United States Army in War and
Peace (New York: G. P. Putnam’s Sons,
1937); Russell F. Weigley, History of the
United States Army (New York: Macmillan
Co., 1967).

2. Washington to the President of Congress,
20 Jul 1775, in John C. Fitzpatrick, ed., The
Writings of George Washington From the
Original Manuscript Sources, 1745-1799, 39
vols. (Washington: Government Printing Of-
fice, 1931-44), 3: 350.

3. Worthington Chauncey Ford, Gaillard
Hunt, and others, eds., Journals of the Conti-
224

nental Congress, 34 vols. (Washington: U.S.
Government Printing Office, 1904-37), 2:
209.

4. Ford, Journals of the Continental Con-
gress, 2: 191, quote from p. 250; 4: 344; 5:
636, 673; 6: 1006, 1065; 7: 13, 44; Medical
Committee to George Washington, 13 Feb
1777, in Edmund Cody Burnett, ed., Letters
of Members of the Continental Congress, 8
vols. (Washington: Carnegie Institution of
Washington, 1921-36), 2: 249; Gibson, Otto,
p. 109; Jennings Bryan Sanders, Evolution of
Executive Departments of the Continental
Congress (Gloucester, Mass.: Peter Smith,
1971 reprint of 1935 edition), p. 7.

5. Ford, Journals of the Continental Con-
gress, 7: 193. A number of other committees
of the Continental Congress became directly
or indirectly involved in the affairs of the
Hospital Department. Among them were the
so-called Secret Committee and two appointed
at different times to hear John Morgan’s de-
fense of his own conduct as the second
director and his charges against his successor,
William Shippen, and another formed in Febru-
ary 1778 after Rush attacked Shippen. Ford,
Journals of the Continental Congress, 7: 206,
219, 225; 8: 626; Bell, Morgan, pp. 211-12,
219; Corner, Rush, p. 136.

6. George B. Griffenhagen, Drug Supplies
in the American Revolution, U.S. National
Museum Bulletin 225 (Washington: Smith-
sonian Institution, 1961), pp. 121-22; Ford,
Journals of the Continental Congress, 3: 261;
5: 528; 6: 990; 17: 708; Claude Halstead Van
Tyne, The War of Independence, 2 vols. (Bos-
ton: Houghton Mifflin Co., 1929), 2: 284.

7. Ford, Journals of the Continental Con-
gress, 2: 211.

8. William Frederick Norwood, “The Enig-
ma of Dr. Benjamin Church, A High-Level
Scandal in the American Colonial Army Medi-
cal Service,” Medical Arts and Sciences 10
(1956): 82; Church to Samuel Adams, 23 Aug
1775 in Allen French, General Gage’s In-
formers (Ann Arbor: University of Michigan
Press, 1932), pp. 173-75; John Sullivan to
John Langdon and Josiah Bartlett, 4 Sep 1775,
in John Sullivan, Letters and Papers of Major
General John Sullivan, 1771-1777, 3 vols.,
Collections of New Hampshire Historical

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Society (Concord: New Hampshire Historical
Society, 1930), 1: 82-83.

9. Norwood, “Church,” p. 82; Howard
Lewis Applegate, “The American Revolution-
ary War Hospital Department,” Military
Medicine 126 (1961): 296; Robert Jackson,
A System of Arrangement and Discipline for
the Medical Department of Armies (London:
John Murray, 1805), p. 59; Edwin P. Wolfe,
“The Genesis of the Medical Department of
the United States Army,” Bulletin of the New
York Academy of Medicine, 2d ser. 5
(1929): 829-30.

10. General Orders, 7 Sep 1775, Fitzpatrick,
Washington, 3: 480-81, quote from p. 481;
Church to Samuel Adams, 23 Aug 1775,
French, Gage, pp. 174-75.

11. General Orders, 7 Sep 1775, Fitzpatrick,
Washington, 3: 481.

12. Quote from Sullivan to John Langdon
and Josiah Bartlett, Sullivan, Letters, 1: 82;
Petition to Sullivan, 1775, Sullivan, Letters,
1: 84.

13. Ford, Journals of the Continental Con-
gress, 2: 249-50, quote from p. 249.

14. Washington’s Orders, 14 and 18 Sep
1775, and Horatio Gates to Church, 24 Sep
1775, in Peter Force, ed., American Archives:
Fourth and Fifth Series, Containing a Docu-
mentary History of the United States of
America From March 7, 1774, to the Defini-
tive Treaty of Peace With Great Britain,
September 3, 1783, 9 vols. (Washington: M.
St. Clair Clarke and Peter Force, 1848-53),
3: 769, 770, quote from Washington's Orders,
30 Sep 1775, pp. 857-58; General Orders, 28
Sep 1775, Fitzpatrick, Washington, 3: 524.

15. Quote from James Warren to John
Adams, 1 Oct 1775, in Warren-Adams Letters,
Being Chiefly a Correspondence Among John
Adams, Samuel Adams, and James Warren,
2 vols., Massachusetts Historical Society Col-
lections, 5th ser. 72 (1917), 73 (1925), vol.
1, p. 121; Henry Ward to Gen Nathanael
Greene, 26 Sep 1775, Force, American
Archives, 4th ser. 3: 809; Washington to the
President of Congress, 5 Oct 1775, Fitzpatrick,
Washington, 4: 9-11; Norwood, “Church.”
pp. 83-84.

16. Quote from John Adams to James War-
ren, 18 Oct 1775, Burnett, Letters, 1: 234;
Notes to Chapter 2

Carl Van Doren, Secret History of the Ameri-
can Revolution . . . (New York: Viking Press,
1941), pp. 19, 21; John Adams to Abigail
Adams, 13 Oct 1775, in John Adams, Letters
of John Adams Addressed to His Wife, ed.
by Charles Francis Adams, 2 vols. (Boston:
Charles C. Little and James Brown, 1841),
1: 65-66; Council of War, Cambridge, 4
Oct 1775, and Massachusetts House of Repre-
sentatives, 28 Oct 1775, Force, American
Archives, 4th ser. 3: 958, 1479n-83n, 1485-
86; Samuel Adams to James Warren, 13 Oct
1775, and James Warren to Samuel Adams,
26 Oct 1775, Warren-Adams Letters, 1: 141-
42; 2: 424.

17. Quote from Council of War, 4 Oct
1775, Force, American Archives, 4th ser.
3: 958, 1159-60; General Orders, 3 Oct 1775,
and Washington to the President of Congress,
S Oct 1775, Fitzpatrick, Washington, 4: 2,
9-11; Norwood, “Church,” pp. 85-86, 87.

18. Quote from John Adams to Benjamin
Kent, 22 Jun 1776, Burnett, Letters, 1: 502;
Norwood, “Church,” pp. 85-86, 88-89; Ed-
ward Alfred Jones, The Loyalists of Massachu-
setts: Their Memorials, Petitions, and Claims
(Baltimore: Genealogical Publ. Co., 1969),
p. 87; Washington to Jonathan Trumbull, 15
Nov 1775, Fitzpatrick, Washington, 4: 91;
Ford, Journals of the Continental Congress,
3: 294-95, 4: 352; Massachusetts House of
Representatives, 16 Oct 1775, 26 Oct 1775,
and 11 Nov 1775, and Connecticut Committee
of Safety, 22 Nov 1775, Force, American
Archives, 4th ser. 3: 1464, 1477, 1517-18,
1636-37; John Hancock to Massachusetts
Council, 3 Oct 1777, Burnett, Letters, 2: 506;
James Warren to John Adams, 5 Jun 1776,
Warren-Adams Letters, 1: 254-55.

19. Washington to Richard Henry Lee, 8
Nov 1775, Fitzpatrick, Washington, 4: 76;
John C. Fitzpatrick, ed., The Diaries of George
Washington, 1748-1799, 4 vols. (Boston:
Houghton Mifflin Co., 1925), 2: 195; John
Adams to James Warren, 18 Oct 1775, Bur-
nett, Letters, 1: 234.

20. John Adams to James Warren, 25 Oct
1775, Warren-Adams Letters, 1: 165.

21. Bell, Morgan, p. 717.

22. Barnabas Binney to Solomon Drowne,
quoted in Gibson, Otto, p. 261.

225

23. Bell, Morgan, pp. 143, 179.

24. Quote from Washington to Joseph Reed,
20 Nov 1775, Fitzpatrick, Washington, 4:
104-5; James E. Gibson, “The Role of Dis-
ease in the 70,000 Casualties in the American
Revolutionary Army,” Transactions and
Studies of the College of Physicians of Phila-
delphia, 4th ser. 17 (1949): 122; Bell, Mor-
gan, pp. 180-81, 214; Solomon Drowne,
“Original Letters,” Pennsylvania Magazine of
History and Biography 5 (1881): 112.

25. John Morgan to Washington, quoted in
Gibson, Otto, pp. 117-18; Francis R. Packard,
“Editorial: Washington and the Medical Af-
fairs of the Revolution,” Annals of Medical
History, ns. 4 (1932): 307-8; Frederick E.
Brasch, “The Royal Society of London and
Its Influence Upon Scientific Thought in the
American Colonies,” Scientific Monthly 33
(1931): 459.

26. Griffenhagen, Drug Supplies, p. 113;
Washington to the President of Congress, 31
Dec 1775, Fitzpatrick, Washington, 4: 199;
Bell, Morgan, pp. 183, 214-15; Packard,
“Editorial,” p. 310.

27. Quote from Force, American Archives,
4th ser. 6: 1714n—15n; Packard, “Editorial,”
pp. 307-8; Bell, Morgan, pp. 184-85, 192.

28. General Orders, 3 Jul 1776, Regulations
Agreed Upon Betwixt the Director-General of
the American Hospital and the Regimental
Surgeons and Mates at New-York, and Mor-
gan to Washington, 18 Jul 1776, Force, Ameri-
can Archives, 4th ser. 6: 1271; Sth ser. 1:
108-9, 416; Bell, Morgan, pp. 192, 194;
Ford, Journals of the Continental Congress,
4: 188, 243, 332; 5: 568, 569; Griffenhagen,
Drug Supplies, pp. 112-13.

29. Ford, Journals of the Continental Con-
gress, 5: 568, 569, 570; Bell, Morgan, p. 199.

30. Quote from Col W. Smallwood to
Maryland Council of Safety, Oct 1776, Force,
American Archives, 5th ser. 2: 1100; Ford,
Journals of the Continental Congress, 5: 857,
858; Bell, Morgan, p. 185.

31. General Orders, 2 Aug 1776, Fitz-
patrick, Washington, 5: 366, quote from
Washington to the President of Congress, 24
Sep 1776, 6: 113; John Morgan, A Vindica-
tion of His Public Character . . . (Boston:
Powars and Willis, 1777), xviii; Gen Na-
226

thanael Greene to John Hancock, 10 Oct 1776,
Force, American Archives, 5th ser. 2: 974.

32. Ford, Journals of the Continental Con-
gress, 4: 242-43; 5: 837.

33. Washington to the President of Con-
gress, 26 Apr 1776, Fitzpatrick, Washington,
4: 521; Stringer to Washington, 10 May 1776,
and Washington to Congress, 15 May 1776,
Force, American Archives, 4th ser. 4: 418; 6:
469.

34. Morgan to Samuel Adams, 25 Jun
1776, Force, American Archives, 4th ser. 6:
1069-70, quote from 1069; Force, American
Archives, 4th ser. 6: 1714n.

35. Horatio Gates to Egbert Benson, 22 Aug
1776, with copy to Morgan, and General
Orders, General Gates, 31 Aug 1776, Force,
American Archives, 5th ser. 1: 1114, 1271,
quote from Morgan to the President of Con-
gress, 12 Aug 1776, 1: 921; Bell, Morgan,
p. 193; Ford, Journals of the Continental
Congress, 5: 673, 843.

36. Virginia Convention, 21 May 1776, Vir-
ginia Convention, 15 Jun 1776, and Conti-
nental Congress, 18 May 1776, Force,
American Archives, 4th ser. 6: 1533, 1572-73,
1673.

37. Thomas Heyward, Jr., to Morgan, 4
Sep 1776, Burnett, Letters, 2: 69, quote from
Oliver Wolcott to Matthew Griswold, 18 Nov
1776, 2: 158.

38. Quote from Congress to Shippen, 16 Jul
1776, quoted in Gibson, Otto, p. 195; Bell,
Morgan, p. 220; Caspar Wistar, Eulogium on
Dr. William Shippen (Philadelphia: Thomas
Dobson and Son, 1818), pp. 9-12, 15-16;
Bell, “Students,” p. 3; Ford, Journals of the
Continental Congress, 5: 562; Middleton,
“Shippen,” p. 539.

39. Ford, Journals of the Continental Con-
gress, 6: 857-58, 989, quote from 857-58;
Shippen to Washington, 20 Oct 1776, and
Shippen to the President of Congress, 9 Nov
1776, Force, American Archives, 5th ser. 2:
1280; 3: 618; Washington to Shippen, 3 Nov
1776, Fitzpatrick, Washington, 6: 239.

40. Washington to John Morgan, 6 Jan
1779, Fitzpatrick, Washington, 13: 482; Mor-
gan, Vindication, xvii—xviii; Ford, Journals of
the Continental Congress, 6: 991; Gen Nathan-
ael Greene to the President of Congress, 16

THE ARMY MEDICAL DEPARTMENT,

1775-18138

Dec 1776, Shippen to Lee, 17 Dec 1776, and
Council of Safety to the President of Congress,
22 Dec 1776, Force, American Archives, 5th
ser. 3: 1246, 1259, 1358.

41. Ford, Journals of the Continental Con-
gress, 7: 24.

42. Washington to Morgan, 6 Jan 1779,
Fitzpatrick, Washington, 13: 481, quotes from
Washington to Morgan, 18 Jan 1777, and to
President of Congress, 26 Jan 1777, 7: 28, 64.

43. Samuel Adams to John Adams, 9 Jan
1777, Burnett, Letters, 2: 211, 212.

44. Morgan, Vindication, pp. v, xviii, quote
from pp. xxv-xxvi; Bell, Morgan, pp. 207,
214-15, 216, 217-18; Pennsylvania Packet, 1
Jul 1779.

45. Ford, Journals of the Continental Con-
gress, 14: 724, quote from 8: 626; Statement
of Henry Laurens, 3 Jun 1779, Burnett, Let-
ters, 4: 247-48; Bell, Morgan, pp. 213-14,
219.

46. Rush to Lee, 14 Jan 1777, Butterfield,
Letters of Rush, 1: 129; Corner, Rush, p. 131.

47. Washington to Cochran, 20 Jan 1777, to
the President of Congress, 14 Feb 1777 and
14 Mar 1777, Fitzpatrick, Washington, 7: 45,
149-50, 287-88, Washington to Shippen, 27
Jan 1777, quoted in Gibson, Otto, p. 134;
Ford, Journals of the Continental Congress,
7. 162.

48. Ford, Journals of the Continental Con-
gress, 7: 178, 193, 199-200, 206, 219, 225;
Washington to John Warren, 23 Feb 1777,
quoted in Gibson, Otto, p. 139.

49. See Appendix D for the complete text
of the law of 7-8 April and also Corner,
Rush, p. 131; Ford, Journals of the Conti-
nental Congress, 7: 162, 198-99.

50. Adams, Letters to His Wife, 1. 209;
Roger Sherman to Jonathan Trumbull, 17 Apr
1777, Burnett, Letters, 2: 329; Ford, Journals
of the Continental Congress, 7: 178; Matthew
Thornton to Jonathan Potts, 12 Apr 1777,
Burnett, Letters, 2: 320n—21n; John Hancock
to Washington, 9 Apr 1777, in Jared Sparks,
ed., Correspondence of the American Revolu-
tion: Being Letters of Eminent Men to George
Washington, From the Time of His Taking
Command of the Army to the End of His
Presidency, 4 vols. (Boston: Little, Brown and
Co., 1853), 1: 364.
Notes to Chapter 2

51. Ford, Journals of the Continental Con-
gress, 7: 162, 257; 18: 878; William Shippen,
“Text of William Shippen’s First Draft of a
Plan for the Organization of the Military Hos-
pital During the Revolution,” Annals of Medi-
cal History 1 (1917-18): 176.

52. Ford, Journals of the Continental Con-
gress, 7: 289-90.

53. Quoted in Gibson, Otto, p. 138; Letter
of 13 Apr 1777, Adams, Letters to His Wife,
1: 213; Ford, Journals of the Continental Con-
gress, 7: 253-54; Washington to the President
of Congress, 14 Feb 1777, Fitzpatrick, Wash-

ington, 7: 149; Butterfield, Letters of Rush,
1: 121n.
54. Wistar, Shippen, pp. 9-13, 28, 31,

quotes from pp. 15-16, 36; Bell, Morgan,
p. 220; Whipple, Evolution, p. 11; Bell,
“Students,” p. 3; Betsy Copping Corner, Wil-
liam Shippen, Jr.: Pioneer in American Medical
Education (Philadelphia: American Philosoph-
ical Society, 1951), pp. 117-18, 122, 123.

55. Bell, Morgan, p. 220; Benedict Arnold,
The Present State of the American Rebel
Army, Navy and Finances, Transmitted to the
British Government, October 1780, ed. by Paul
Leicester Ford (Brooklyn: Historical Printing
Club, 1891), p. 10; Corner, Shippen, p. 112;
Wistar, Shippen, p. 29.

56. Washington to John Augustine Washing-
ton, 10 Jun 1778, Fitzpatrick, Washington,
12: 43.

57. Quote from letter of 13 Apr 1777,
Adams, Letters to His Wife, 1: 212-13.

58. Griffenhagen, Drug Supplies, pp. 121-
22.

59. Washington to the President of Con-
gress, 17 Nov 1777, and Washington to Gov
William Livingston, 31 Dec 1777, Fitzpatrick,
Washington, 10: 76, 233; Ford, Journals of
the Continental Congress, 8: 608-9; 10: 941;
John W. Jordan, “The Military Hospitals at
Bethlehem and Lititz During the Revolution,”
Pennsylvania Magazine of History and Biog-
raphy 20 (1896): 147.

60. Washington to Gov William Livingston,
31 Dec 1777, Fitzpatrick, Washington, 10:
233.

61. Corner, Rush, p. 133, quote from p.
135; Ford, Journals of the Continental Con-
gress, 10: 23.

227

62. John Witherspoon to William Churchill
Houston, 27 Jan 1778, James Lovell to John
Langdon, 8 Feb 1778, and Henry Laurens to
the Governor of Rhode Island, 3 Jan 1778,
Burnett, Letters 3: 59, 97; 13: 11; Rush to
John Adams, 21 Oct 1777, Rush to John
Adams, 31 Oct 1777, and Rush to William
Duer, 8 Dec 1777, Butterfield, Letters of Rush,
1: 159-62, 165, 171, 172-73; Ford, Journals
of the Continental Congress, 10: 9, 23, 93,
128, 129; Applegate, “Hospital Department,”
pp. 301-2; Van Tyne, War, 2: 284; Potts to
Medical Committee, 10 Apr 1779, in Wash-
ington, Library of Congress, Manuscript Di-
vision, Papers of Jonathan Potts.

63. Burnett, Letters, 5: 287-88, quote from
Committee at Headquarters to President of
Congress, 10 May 1780, 5: 134.

64. Cochran to Jonathan Potts, 18 Mar
1780, in Thornton Chard, “Excerpts From the
Private Journal of Doctor John Cochran,”
New York History 42 (1944): 375.

65. General Orders of 2 Jan, 20 Aug 1778,
26 Mar, 6 May, 16 Jun, 23 Dec 1780, Wash-
ington to Committee of Conference, 8 Jan
1779, Fitzpatrick, Washington, 10: 248; 12:
338; 13: 490; 18: 160, 337-38; 19: 17-18;
21: 9, quote from Washington to Committee
of Congress, 29 Jan 1778, 10: 394.

66. Ford, Journals of the Continental Con-
gress, 8: 626. It is difficult to be precise about
the position of Rickman in the years 1776-
80. He functioned independently of the Direc-
tor of the Hospital Department and his prin-
cipal “territory” during this period was Vir-
ginia. It appears that he was never officially
designated Deputy Director General for the
Southern Department. Nevertheless, in July
1780, Gen. Horatio Gates referred to Rick-
man as the “Director of the Hospitals in the
Southern Department” (Gates to Director of
the Hospitals in the Southern Department, 19
Jul 1780, in Horatio Gates, “Letters of Gen-
eral Gates on the Southern Campaign,” Maga-
zine of American History 5S [1880]: 284)
and as “Director to the General Hospital of
the Southern Army,” (Gates to President of
the Board of War, Gates, “Letters,” p. 288),
which suggests that General Gates considered
Rickman’s authority to extend beyond Vir-
ginia. In February 1781, furthermore, in a
228

communication from the Continental Congress
to Thomas Bond, Rickman was referred to as
the “late deputy director” (Ford, Journals of
the Continental Congress, 19: 118). One can
only conclude that in this instance, as in
others, titles were used casually and the limits
of the authority of the individual officer not
always clearly marked.

67. The terms used in the legislation and
other documents of the period are often con-
fusing to the modern reader. It should be
borne in mind that although Army physicians
were repeatedly referred to as “medical of-
ficers” in legislation concerning the Hospital
Department, they had no rank in the period
1775-1818.

68. Washington to Maj Gen Alexander
McDougall, 5 Apr 1779, and Washington to
Dr. Isaac Foster, 28 Mar 1780, Fitzpatrick,
Washington, 14: 339; 18: 174; Ford, Journals
of the Continental Congress, 15: 1214, 1216,
1294-96; 18: 887.

69. Burnett, Letters, 5: 112n, also Nathaniel
Scudder to Nathaniel Peabody, 6 Dec 1779,
and Committee at Headquarters to President
of Congress, 18 Jul 1780, 4: 533; 5: 275;
Ford, Journals of the Continental Congress,
16: 10-12; 19: 68-69; Washington to John
Cochran, 6 Nov 1780, Fitzpatrick, Washington,
20: 307; William T. R. Saffell, Records of
the Revolutionary War . (New York:
Pudney & Russell, 1859), pp. 402-3.

70. Ford, Journals of the Continental Con-
gress, 10: 101; 14: 1, 733; Washington to Mor-
gan, 5 Jan 1779, to Committee of Conference,
8 Jan 1779, and to Council of General Officers,
26 Jul 1779, Fitzpatrick, Washington, 13:
479, 489; 15: 488-89; James Lovell to John
Langdon, 8 Feb 1777, Richard Henry Lee to
Shippen, 18 Apr 1779, and John Fell Diary,
entry for 16 Apr 1779, Burnett, Letters, 3:
77; 4: 159, 163; Rush to John Adams, 8
Feb 1778, Rush to Daniel Roberdeau, 9 Mar
1778, and Rush to John Adams, 12 Feb 1812,
Butterfield, Letters, 1: 199-200, 204-7; 2:
1122.

71. Shippen to Lee, 16 Apr 1780, and
Cochran to Jonathan Potts, 18 Mar 1780,
quoted in Gibson, Otto, pp. 253-54, 256.

72. Quoted in Gibson, Otto, p. 275; Bell,
Morgan, p. 227.

THE ARMY MEDICAL DEPARTMENT,

1775-1818

73. Quoted in Bell, “Students,” p. 7; Rush
to John Adams, 8 Aug 1777, and Richard
Peters to Secretary of State Pickering, 7 Oct
1797, Butterfield, Letters, 1: 153; 2: 1210.

74. Pennsylvania Packet, 9 Dec 1780.

75. Bell, Morgan, pp. 229, 230, 233.

76. Quotes from Verdict of Court-Martial,
27 Jun 1780, quoted in Gibson, Otto, pp.
263-64; Ford, Journals of the Continental Con-
gress, 17: 744-45.

77. Pennsylvania Packet, 26 Jun 1779, 18
Nov 1780, 25 Nov 1780, 6 Dec 1780, 9
Dec 1780; Rush to John Adams, 8 Aug 1777,
Rush to William Duer, 8 Dec 1777, Rush to
Morgan, Jan 1778, and Rush to John Adams,
12 Feb 1812, Butterfield, Letters, 1: 153,
173, 226; 2: 1121.

78. Quoted in Ford, Journals of the Conti-
nental Congress, 17: 638; Washington to Presi-
dent of Congress, 15 Jul 1780, quoted in Gib-
son, Otto, p. 264.

79. Corner, Rush, p. 137.

80. John Mathews to Washington, 15 Sep
1780, Burnett, Letters, 5: 372-73; Ford, Jour-
nals of the Continental Congress, 16: 708;
17: 879-88, 908.

81. John Mathews to Washington, 15 Sep
1780, Burnett, Letters, 5: 372-73; Joseph
Jones to Washington, 2 Oct 1780, in Joseph
Jones, Letters of Joseph Jones of Virginia,
1777-1787, ed. by Worthington Chauncey
Ford (New York: New York Times, 1971
reprint of 1889 edition, 1971), pp. 32-33;
Ford, Journals of the Continental Congress,
18: 878, 885, 887-88.

82. Ford, Journals of the Continental Con-
gress, 18: 908-10; Washington to Joseph
Jones, 9 Sep 1780, and General Orders, 19
Oct 1780, Fitzpatrick, Washington, 20: 18-
19, 218; Jones to Washington, 2 Oct 1780,
and to Madison, 17 Oct 1780, Jones, Letters,
pp. 32-33, 36.

83. Ford, Journals of the Continental Con-
gress, 19: 15, quote from 18: 1126; William
Shippen to General Washington, 4 Jan 1781,
in Washington, Library of Congress, Manu-
script Division, Papers of George Washington.

84. Quoted in James Thacher, 4 Military
Journal During the American Revolutionary
War, From 1775 to 1783 . . ., 2d ed. (Boston:
Cottons & Barnard, 1827), p. 252; Ford,
Notes to Chapter 2

Journals of the Continental Congress, 19: 48,
56, 65; John Cochrane, “Medical Department
of the Revolutionary Army,” Magazine of
American History 12 (1884): 258.

85. Quote from Cochran to Dr. Peter Tur-
ner, 25 Mar 1781, and Cochran to James
Craik, 26 Mar 1781, Cochrane, “Medical De-
partment,” pp. 245, 246.

86. Ford, Journals of the Continental Con-
gress, 19: 68-69.

87. Ford, Journals of the Continental Con-
gress, 19: 292-94; 20: 506.

88. Proceedings of the Board of War, Bur-
nett, Letters, 6: 146-47; Ford, Journals of
the Continental Congress, 20: 570.

89. Ford, Journals of the Continental Con-
gress, 21: 1093; 22: 4-6.

90. Ford, Journals of the Continental Con-
gress, 23: 408-12, 645; General Orders of 6
Aug 1782, Fitzpatrick, Washington, 24: 479.

91. Cochrane, “Medical Department,” p.
252, quote from Cochran to the President
of Congress, 24 May 1781, p. 248; John
Cochran to Thomas Bond, 1781, in Morris-
town, N.J., Morristown Historical Park, John
Cochran Letter Book, microfilm 5168; Ford,
Journals of the Continental Congress, 21:
103; Cochran to Abraham Clark, 28 Feb 1781
and Apr 1781, Chard, “Cochran,” pp. 366-67,
369; Washington to Cochran, 12 Feb 1781,
and to James and Horace Hooker, 25 Feb
1781, Fitzpatrick, Washington, 21: 217, 292-
93.

92. Fitzpatrick, Washington, 24: 489n;
Washington to President of Congress, 15 Dec
1781, 23: 392, quote from Washington to
Gov John Hancock, 14 Jul 1781, 22: 380;
Cochran to John Warren, 30 Jun 1781, Chard,
“Cochran,” p. 370; Victor Leroy Johnson,
“Robert Morris and the Provisioning of the
American Army During the Campaign of
1781,” Pennsylvania History 5 (1939): 11;
Pennsylvania Packet, 14 Nov 1780, p. 2.

93. Ltrs, Robert Morris to Thomas Bond,
19 Feb 1782 and 19 Jun 1783, Xeroxes of
letters held by Library of Congress, obtained
from Miss Elizabeth Thomson.

94. Cochrane, “Medical Department,” p.
231.

95. Cochran to George Campbell and to
Abraham Clark, 2 and 30 Apr, 8 May 1781,

229

quote from Cochran to Robert Morris, 26
Jul 1781, Chard, “Cochran,” pp. 368-69, 372;
Cochrane, “Medical Department,” p. 252;
Ford, Journals of the Continental Congress,
21: 1072-73; John Cochran to Peter Turner,
25 Mar 1781, Cochran Letter Book.

96. Cochrane, “Medical Department,” p.
254; Ford, Journals of the Continental Con-
gress, 21: 81-82; John Cochran to Samuel
Huntington, 24 May 1782, Cochran Letter
Book.

97. Ford, Journals of the Continental Con-
gress, 29: 208; Saffell, Records, pp. 406-17.

98. Quote from Cochran to Hagen, 8 May
1781, Chard, “Cochran,” p. 370.

99. Quote from Cochran to Hagen, 8 May
1781, Chard, “Cochran,” p. 370; John Coch-
ran to Board of War, 4 Jul 1781, and to
Robert Morris, 26 Jul 1781, Cochran Letter
Book; Washington to Maj Gen William Heath,
1 Aug 1781, and Washington to the Board of
War, 5 Aug 1781, Fitzpatrick, Washington,
22: 441, 463; Ford, Journals of the Conti-
nental Congress, 20: 625; 21: 979.

100. Ford, Journals of the Continental Con-
gress, 21: 980.

101. Ford, Journals of the Continental Con-
gress, 22: 7; The President of Congress to
Cochran, 25 Sep 1781, Burnett, Letters, 6:
22s.

102. Washington's letters to Secretary of
War, 16 Aug 1782, to Sir Guy Carleton, 18
Aug 1782, to Heath and Knox, 23 Sep 1782,
Fitzpatrick, Washington, 25: 26, 38, 196.

103. Richard Peters, by order to John
Cochran, 10 Oct 1781, Cochran Letter Book,
with quote from Cochran to Binney, 22 Oct
1781; Cochran to President of Congress, 10
Oct 1781, to James Craik, 10 Oct 1781, and
Cochran to John Warren, 10 Oct 1781, Chard,
“Cochran,” pp. 363-64, 365, 372; Cochran to
Barnabas Binney, 22 Oct 1781, Pennsylvania
Magazine of History and Biography 5 (1881):
230.

104. John Cochran to Barnabas Binney, 22
Oct 1781, and Cochran to John Warren, 22
Feb 1781, Cochran Letter Book; Cochran to
Warren, 10 Oct 1781, Chard, “Cochran,”
p.: 372.

105. Report of Nov 1782, Cochran to Bin-
ney, 22 Oct 1781, and Cochran to Richard
230

Peters, 20 Oct 1781, Cochran Letter Book;
Cochran to Warren, 10 Oct 1781, Chard,
“Cochran,” p. 372.

106. Quoted in Ford, Journals of the Conti-
nental Congress, 25: 740; John C. Fitzpatrick,
The Spirit of the Revolution (Boston: Hough-
ton Mifflin Co., 1924), p. 211.

107. Jones, Works, pp. 152-54.

CHAPTER 3

1. For the location of towns in the vicinity
of Boston mentioned in the text, see Map 1.
Unless otherwise indicated, the account of
the Boston area is based upon these sources:
Bell, Morgan; Brown, Medical Department;
Cash, Medical Men; and Duncan, Medical
Men. Except where otherwise indicated, sta-
tistics throughout this and subsequent chapters
are based on Charles H. Lesser, ed., The
Sinews of Independence: Monthly Strength
Reports of the Continental Army (Chicago:
University of Chicago Press, 1976). It should
be noted, however, that, as Lesser himself
points out, there are many serious difficulties
involved in any attempt to rely upon statis-
tics concerning the rate of sickness in the
Continental Army during the Revolution. De-
spite Washington's concern for the keeping of
accurate records, care and precision with
statistics were not generally characteristic of
those submitting returns in this period, partic-
ularly before the winter of 1778-79, and the
gathering of accurate figures was often impos-
sible. Statistics obtained from different re-
ports apparently covering the same units for
the same period of time may, therefore, vary.
A return of 29 June 1776 in Lesser, for ex-
ample, lists strength and sickness statistics at
variance with those cited in a strength report
for the preceding day by Washington, as
published in Fitzpatrick, Washington, 5: 194n,
but the Fitzpatrick citation may not include
all of the units included in the Lesser return.
Attempts to use the returns published in
Lesser in analyzing the work of the Hospital
Department are complicated by the fact that
the pertinent column headings appear some-
what ambiguous to the modern researcher;
“sick present,” used in the official army
monthly reports, may or may not include

THE ARMY MEDICAL DEPARTMENT,

1775-1818

the figures for regimental and flying hospitals,
while “sick absent” may include those in
general hospitals, those sick or convalescent
at home or in the care of civilians outside
camp, and those who deserted after their
discharge from these facilities but before re-
turning to their units (see Fitzpatrick, Wash-
ington, 10: 526-27, for example). Hospital
Department returns, on the other hand, often
use another ambiguous category, “sick in
camp,” or a similar term which, because of
the manner in which it is used, clearly in-
cludes regimental and flying hospitals but may
or may not include the sick of units stationed
at some distance from the main body of the
army. Figures given by the department's re-
port are, with some exceptions, significantly
smaller than those cited by Lesser, a situa-
tion which may reflect those inaccuracies in
regimental returns sent directly to the Adju-
tant General which moved General Washing-
ton to angry comment in May 1778
(Fitzpatrick, Washington, 11: 454-55). The
number of officers sick, when available, is
listed separately in Lesser, but even when
given, the figure is often partial, limited in
many instances to the officers of the artillery.
Percentages in this and following chapters
concerning the Revolution have, therefore,
been calculated from figures for the rank and
file alone to establish a uniform basis for
comparisons.

Also consulted for the preceding paragraph
were: Gibson, “Role of Disease”; and James
Stevens, “Revolutionary Journal,” Essex Insti-
tute Historical Collections 48 (1912): 53.

2. Church to Samuel Adams, 23 Aug 1775,
French, Gage, pp. 175-76.

3. Quote from Morgan to Washington, 12
Dec 1775, Force, American Archives, 4th
ser. 4: 263; Church to Samuel Adams, 23
Aug 1775, French, Gage, pp. 175-76. Most
of the papers of the Board of War from the
period of the American Revolution were de-
stroyed in a fire on 8 November 1800 and
the surviving records sustained further serious
losses when the British looted the fireproof
room which contained them in 1814. Wash-
ington, National Archives, Preliminary Inven-
tories: War Department Collection of
Revolutionary War Records (Washington:
Notes to Chapter 3

National Archives and Records Service,
General Services Administration, 1970), p. 1.

4. Church to Samuel Adams, 23 Aug
1775, French, Gage, pp. 176-77; Norwood,
“Church,” p. 82; John Warren to John Han-
cock, Oct 1775, Duncan, Medical Men, p. 67;
Return of the Sick & Wounded in the General
Hospital at Cambridge & Roxbury, 25 Nov-
2 Dec 1775, in Washington, National Archives,
War Department Collection of Revolutionary
War Records, Record Group 93, Revolution-
ary War Rolls 1775-83, Microfilm Publica-
tion M246, Miscellaneous, Hospital Depart-
ment, roll 135, folder 3-1, item 15.

5. Quote from General Orders, 29 Aug
1775, in Washington, National Archives, War
Department Collection of Revolutionary War
Records, Record Group 93, Miscellaneous
Numbered Records, 1775-84, series 6, Micro-
film Publication M859, roll 2, frame 154;
Fitzpatrick, Washington, 3: 439-40.

6. Gordon, Aesculapius, p. 241; Returns of
26 Nov-2 Dec 1775, RG 93, M246, folder
3-1, item 15.

7. Morgan to Washington, 12 Dec 1775,
Duncan, Medical Men, p. 80.

8. Morgan to Washington, 12 Dec 1775,
Duncan, Medical Men, p. 80; Returns of 16
Dec 1775-30 Mar 1776, RG 93, M246, roll
135, folder 3-1, items 17-27.

9. Returns of 16 Dec 1775-30 Mar 1776,
RG 93, M246, roll 135, folder 3-1, items
17-27.

10. Quote from Morgan to Washington,
12 Dec 1775, Force, American Archives, 4th
ser. 4: 263; Washington's letters during the
period, Fitzpatrick, Washington, 4: 118, 145-
62; Robert H. Harrison to Council of
Massachusetts, 3 Dec 1775, Force, American
Archives, 4th ser. 6: 168; Massachusetts Pro-
vincial Congress, quoted in Duncan, Medical
Men, p. 53.

11. Thacher, Journal, p. 35; Morgan, Vindi-
cation, p. 3; Returns of 13 Jan, 30 Mar 1776,
RG 93, M246, roll 135, folder 3-1, items
20-27.

12. Thacher, Journal, pp. 45-46; Gibson,
Otto, pp. 90, 93; General Orders, 25 Mar
1776, Fitzpatrick, Washington, 4: 430; Mor-
gan, Recommendation.

13. Morgan to a Committee of the Massa-

231

chusetts Assembly, 11 Apr 1776, Force,
American Archives, 4th ser. 5: 859; 6: 176n;
Ephraim Eliot, “Account of the Physicians of
Boston,” Proceedings of the Massachusetts
Historical Society 6 (1863-64): 178; Morgan
to Washington, 22 Apr 1776, Force, American
Archives, 4th ser. 5: 1025; Griffenhagen, Drug
Supplies, pp. 114, 115, 121-22; Deposition of
Dr. John Warren, 9 Apr 1776, in Henry
Barton Dawson, Battles of the United States,
2 vols. (New York: Johnson, Fry and Co.,
1858), 2: 97.

14. Griffenhagen, Drug Supplies, pp. 112—
13, 115; Washington to Morgan, 3 Apr 1776,
Duncan, Medical Men, p. 114; Morgan to
Washington, 22 Apr 1776, Force, American
Archives, 4th ser. 5: 1024; Gibson, Otro.
p. 93; Morgan, Vindication, p. 4.

15. General Orders, 4 Mar 1776, Fitzpat-
rick, Washington, 4: 368-69; Gibson, “Role
of Disease,” p. 122.

16. Morgan, Vindication, pp. 3-4; Charles
Lee to President of Congress, 9 Feb 1776,
Force, American Archives, 4th ser. 4: 965;
Washington to Morgan, 3 Apr 1776, and Mor-
gan to Washington, 22 Apr 1776, Force,
American Archives, 4th ser. 5: 783-84, 1024.

17. Unless otherwise indicated, the section
on the Northern Department is based on the
following sources: Brown, Medical Depart-
ment; Duncan, Medical Men; Gibson, Otto;
and Henry B. Carrington, Battles of the Ameri-
can Revolution, 1775-1781: Historical and
Military Criticism With Topographical Illustra-
tion, 6th ed., revised (New York: A. S.
Barnes & Co., 1968). The preceding paragraph
is also based on Gibson, “Role of Disease,”
p. 122; and Schuyler to Samuel Stringer, 27
Aug 1775, Force, American Archives, 4th ser.
3: 443.

18. Ford, Journals of the Continental Con-
gress, 2: 249-50; Schuyler to Stringer, 27 Aug
1775, Force, American Archives, 4th ser. 3:
443,

19. Arnold to Washington, 27 Feb 1776,
Force, American Archives, 4th ser. 4: 1513;
Lewis Beebe, Journal of Dr. Lewis Beebe
(New York Times & Arno Press, 1971), pp.
325-27; Kenneth Lewis Roberts, ed., March
to Quebec: Journals of the Members of Ar-
nold’s Expedition (New York: Doubleday,
232

Doran & Co., 1938), pp. 121, 195; John
Codman, Arnold's Expedition to Quebec (New
York: Macmillan Co., 1902), pp. 163, 186.

20. Arnold to Schuyler, 10 May 1776, and
Washington's General Orders, 20 May 1776,
Force, American Archives, 4th ser. 6: 452,
525; Gibson, “Role of Disease,” p. 123; Beebe,
Journal, p. 328; Arnold to Washington, 8
May 1776, Maj Gen John Thomas to Wash-
ington, 8 May 1776, and Arnold to commis-
sioners in Canada, 15 May 1776, Sparks,
Correspondence, 1: 194, 197-99, 516; Timo-
thy Bedel to Brig Gen Arnold, 10 May 1776,
RG 93, M859, roll 101, frame 168.

21. Stringer to Washington, 10 May 1776,
Force, American Archives, 4th ser. 6: 417-18;
Washington to Congress, 15 May 1776, Fitz-
patrick, Washington, 5: 46; Ford, Journals
of the Continental Congress, 4: 378.

22. Quote from Beebe, Journal, p. 330;
Ford, Journals of the Continental Congress,
4: 344; Potts to Continental Congress, 29 Apr
1776, Gibson, Otto, p. 105; Washington to
President of Congress, 26 Apr 1776, Fitz-
patrick, Washington, 4: 520-21.

23. Schuyler to Washington, 22 May 1776,
Force, American Archives, 4th ser. 6: 586.

24. Arnold to Schuyler, 13 Jun 1776, Mor-
gan to Samuel Adams, 25 Jun 1776, Force,
American Archives, 4th ser. 6: 1039, 1069,
quote from extract of letter from John Adams,
26 Jun 1776, 6: 1083; Gates to John Adams,
24 Jun 1776, in Bernard Knollenberg, ed.,
“The Correspondence of John Adams and
Horatio Gates,” Proceedings of the Massachu-
setts Historical Society 67 (1941-44): 145;
Arnold to Washington, 25 Jun 1776, and
Arnold to Schuyler, 6 Jun 1776, Sparks,
Correspondence, 1: 237-38, 526; Bell, Mor-
gan, p. 189.

25. Quotes from Beebe, Journal, pp. 333,
334, 335-36.

26. Stringer to Potts, 7 Jul 1776, in Phila-
delphia, Historical Society of Pennsylvania,
Manuscript Department, Papers of Jonathan
Potts, 1766-80, 1: 70; Morgan to Samuel
Adams, 26 Jun 1776, and Gates to Moses
Morse, 12 Jul 1776, Force, American Ar-
chives, 4th ser. 6: 1069-70; Sth ser. 1: 238;
Beebe, Journal, p. 343; John Trumbull, Auto-
biography, Reminiscenses and Letters of John

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Trumbull, From 1756 to 1841 (New Haven:
B. L. Hamlen, 1841), p. 28; Ltr, Dr. Meyrich,
1835, and John Trumbull to Governor of
Connecticut, Trumbull, Autobiography, pp.
300, 304; Morgan, Vindication, pp. 50, 52;
Ford, Journals of the Continental Congress,
5: 424; Washington to President of Congress,
9 Jun 1776, Fitzpatrick, Washington, 5: 111-
12; Griffenhagen, Drug Supplies, p. 118;
Gibson, “Role of Disease,” p. 124.

27. Quote from Stringer to Gates, 24 Jul
1776, Force, American Archives, 5th ser. 1:
651; Beebe, Journal, p. 344; John Trumbull
to Governor of Connecticut, 12 Jul 1776,
Trumbull, Autobiography, p. 302; Ltr, Lt
Col Israel Shreve to Mary Shreve, 18 Jul
1776, Shreve copybook in the family collec-
tion of Mr. and Mrs. Charles J. Simpson,
Potomac, Maryland.

28. Quote from Stringer to Potts, 7 Jul
1776, Potts Papers, 1: 70; Stringer to Gates,
24 Jul 1776, Force, American Archives, Sth
ser. 1: 651-52; Return of the Sick of the
General Hospital at Fort George From the
12th to the 26th July 1776 Inclusive, RG 93,
M246, roll 135, folder 3-1, item 53.

29. Stringer to Gates, 24 Jul 1776, Force,
American Archives, 5th ser. 1: 652.

30. Morgan to Potts, 28 Jul 1776, Potts
Papers, 1: 77; Griffenhagen, Drug Supplies,
pp. 118-19; Morgan, Vindication, p. 20.

31. Stringer to Potts, 2 Aug 1776, Potts to
Morgan, 10 Aug 1776, and Stringer to Potts,
7 Sep 1776, Potts Papers, 1: 84, 87, 98, quote
from McHenry to Potts, 21 Aug 1776, 1: 90;
Gates to Congress, 29 Jul 1776, Force, Ameri-
can Archives, 5th ser. 1: 649; Griffenhagen,
Drug Supplies, pp. 118-19; McHenry to Potts,
21 Aug 1776, Gibson, Otto, p. 110.

32. Quote from Potts to Samuel Adams,
10 Aug 1776, Duncan, Medical Men, p. 101;
Potts to Morgan, 10 Aug 1776, and Stringer
to Potts, 17 Aug 1776, Gibson, Otto, pp. 107,
109.

33. Stringer to Potts, 17 Aug 1776, and
Gates to Washington, 28 Aug 1776, Gibson,
Otto, p. 109, quote from p. 103; James W. Gib-
son, “Smallpox and the American Revolution,”
Genealogical Magazine and Historiograph-
ical Chronicle 51 (1948): 56; Ltr, Richard
Blanco to author, 22 Apr 1975, p. 2; S.
Notes to Chapter 3

Adams to J. Adams, 16 Aug 1776, in Samuel
Adams, The Writings of Samuel Adams, ed.
Harry Alonzo Cushing, 4 vols. (New York:
Octagon Books, 1968), 3: 310-11.

34. Force, American Archives, 5th ser. 1:
1271, quote and data from Gates to Egbert
Benson, 22 Aug 1776, 1: 1114; Gates to
President of Congress, 2 Sep 1776, Gibson,
Otto, pp. 101-2.

35. Schuyler to New York Committee of
Safety, 9 Sep 1776, Force, American Archives,
5th ser. 2: 685; Griffenhagen, Drug Supplies,
p. 120; Beebe, Journal, pp. 345-46, 350, 356;
Report of meeting of regimental surgeons of
31 Aug 1776, Force, American Archives,
Sth ser. 1: 226.

36. Quote from Beebe, Journal, p. 358;
Griffenhagen, Drug Supplies, p. 119.

37. Trumbull to Schuyler, 10 Sep 1776,
Force, American Archives, 5th ser. 2: 279-80.

38. Dr. Samuel Wigglesworth to New
Hampshire Committee of Safety, 27 Sep 1776,
and Resolve of Continental Congress, 25 Sep
1776, Force, American Archives, 5th ser. 2:
574, 1378; Ford, Journals of the Continental
Congress, 5: 622, 812; William Williams to
Joseph Trumbull, 26 Sep 1776, Burnett, Let-
ters, 2: 104,

39. Quote from Elbridge Gerry to John
Wendell, 11 Nov 1776, Burnett, Letters, 2:
149; Beebe, Journal, p. 357; Craigie to Potts,
3 Oct 1776, and Stringer to Potts, 15 Oct
1776, Griffenhagen, Drug Supplies, p.
Stringer to Gates, 6 Oct 1776, Force, Ameri-
can Archives, Sth ser. 2: 923.

40. Stringer to Potts, 29 Oct 1776 and 3
Nov 1776, Potts Papers, 2: 134, 135-38;
Thacher, Journal, 5 Aug 1776, p. 53.

41. Stringer to Gates, 3 Nov 1776, Force,
American Archives, 5th ser. 3: 506; John
Trumbull to Potts, 8 Aug 1776, Potts Papers,
1: 86.

42. Quote from Report of 27 Nov 1776,
Force, American Archives, 5th ser. 3: 1584;
Ford, Journals of the Continental Congress,
6: 990; Pennsylvania Infantry, 5th Regiment
Orderly Book of the Northern Army at Ti-
conderoga and Mt. Independence From Octo-
ber 17th 1776, to January 8th, 1777, With
Biographical and Explanatory Notes and an

120:

233

Appendix (Albany: J. Munsell, 1859), pp.
19-20, 22.

43. Council of Safety to Potts, 6 Dec 1776,
Thomas Tillotson to Potts, 18 Feb 1777, and
Schuyler to Potts, 22 Mar 1777, Potts Papers,
2: 132, 148, 154; Jordan, “Hospitals,” p. 143;
Pennsylvania Infantry, Orderly Book, pp.
111n-12n; Anthony Wayne to Horatio Gates,
1 Dec 1776, Force, American Archives, 5th
ser. 3: 1031; Ford, Journals of the Conti-
nental Congress, 7: 34.

44. Schuyler to Potts, 22 Mar 1777, Potts
to Gates, 3 Apr 1777, and Potts to Medical
Committee, 3 Apr 1777, Potts Papers, 2: 154,
157, 158; Report of 27 Nov 1776, Force,
American Archives, Sth ser. 3: 1584; Ford,
Journals of the Continental Congress, 6: 990.

45. Return of Stringer, 1 Apr 1777, and
Potts to Gates, 3 Apr 1777, Potts Papers, 2:
156, 157.

46. Shippen’s handwriting is difficult to de-
cipher, but this physician may have been
Forgue.

47. Quote from Shippen to Potts, 18 Apr
1777, Potts Papers, 2: 162; Return of the
officers of the General Hospital Northern De-
partment, no date, Potts Papers, 1: 12. This
document must date after April 1777, when
the position of Assistant Director was first
created, and before the end of the year, when
Potts left the Northern Department (Duncan,
Medical Men, p. 108). The use of the term
“Commissary General” is another example of
the casual use of terminology characteristic of
the period; Potts was referring to the chief
commissary of the Hospital Department, not
the Army's Commissary General.

48. Potts announcement of 7 May 1777,
Return of the Sick in the General Hospital
at Mount Independence, 21 May 1777, and
Potts to Committee of Schenectady, 6 May
1777, Potts Papers, 2: 180, 182, 196.

49. Unless otherwise indicated, the section
on New York, New Jersey, and Pennsylvania
is based on Duncan, Medical Men, and Gib-
son, Otto. Also consulted for the preceding
paragraph was Risch, Quartermaster Support,
p. 11.

50. Bell, Morgan, p. 189; Morgan to New
York Convention, 13 Aug 1776, Force,
American Archives, 5th ser. 1: 499; Morgan,
234

Vindication, pp. 19, 96; Byron Polk Stookey,
A History of Colonial Medical Education: In
the Province of New York, With Its Subse-
quent Development (1767-1830) (Springfield,
Ill.: Charles C Thomas, 1962), p. 74; Griffen-
hagen, Drug Supplies, p. 116.

51. For the location of sites mentioned in
this section, see Map 3. Morgan, Vindication,
pp. 55, 116; W. R. Bett, “John Warren
(1753-1815), Soldier, Anatomist and Sur-
geon,” Medical Press 230 (1953): 137.

52. Morgan, Vindication, pp. 108-9, 117.

53. Morgan, Vindication, pp. 116-17,
quote from p. 118.
54. Morgan, Vindication, p. 18; Carring-

ton, Battles, pp. 211-12.

55. Morgan, Vindication, pp. XXXi—Xxxxii,
12, 20, 128; Griffenhagen, Drug Supplies,
p. 117; Washington to New York Legislature,
8 Sep 1776, Fitzpatrick, Washington, 6: 35-36.

56. Morgan, Vindication, p. 93, quote
from p. 124; Washington to New York Legis-
lature, 12 Sep 1776, and Washington to Presi-
dent of Congress, 14 Sep 1776, Fitzpatrick,
Washington, 6: 48, 54-55.

57. General Orders, 18 Sep
patrick, Washington, 6: 71.

58. Morgan, Vindication, pp. XXXi—Xxxii;
Griffenhagen, Drug Supplies, p. 117; Wash-
ington to Shippen, 3 Nov 1776, Fitzpatrick,
Washington, 6: 239.

59. Morgan, Vindication, pp. xxii—xxiv,
Xxx, 16, 46-47, 142-43, quote from Morgan
to Rush, 20 Oct 1776, p. 142; Bell, Morgan,
p. 200; Washington's General Orders, 2 Sep
1776, Fitzpatrick, Washington, 6: 8.

60. Pennsylvania Journal and Weekly Ad-
vertiser, 17 Jul 1776; Gordon, Aesculapius,
p. 401; Bell, Morgan, p. 197; Van Swieten,
Diseases, p. 7; Butterfield, Letters of Rush 1:
104n. Apparently fewer than 6,000 men ever
reported to the flying camp. See also Chapter
2.

61. Data and quote from Ford, Journals
of the Continental Congress, 5: 808; Mercer
to Washington, 16 Jul 1776, and Shippen to
Congress, 19 Sep 1776, Force, American
Archives, 5th ser. 1: 371; 3: 1298.

62. Shippen Report, 1 Nov 1776, William
Paca to Maryland Council of Safety, 7 Dec
1776, and Shippen to Washington, 8 Dec

1776, Fitz-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

1776, Force, American Archives, 5th ser. 3:
463-64, 1094, 1119; Washington to Board of
War, 4 Dec 1776, and Washington to Shippen,
12 Dec 1776, Fitzpatrick, Washington, 6:
327-28, 362; Bell, Morgan, p. 195; David
Freeman Hawke, Benjamin Rush: Revolu-
tionary Gadfly (Indianapolis: Bobbs-Merrill,
1971), p. 174; Gibson, “Role of Disease,”
pp. 124-25; Gibson, Otto, pp. 120, 123, 199;
Rush to Shippen, 28 Nov 1776, Pennsylvania
Packet, 18 Nov 1780.

63. Gibson does not cite his source for this
figure but it would appear to be a weekly re-
port. Gibson, “Role of Disease,” pp. 124-25;
Morgan, Vindication, pp. 19-20; Hawke, Rush,
p- 174; Ford, Journals of the Continental Con-
gress, 7: 51, 70, 143.

64. Thomas Wharton to Richard Peters, 6
Dec 1776, and Shippen to Lee, 17 Dec 1776,
Force, American Archives, 5th ser. 3: 1094,
1258; Ford, Journals of the Continental Con-
gress, 6: 1006; Jordan, “Hospitals,” p. 141.

65. Jordan, “Hospitals,” pp. 135-41.

66. Jordan, “Hospitals,” pp. 135-41, 143;
Gibson, Otto, p. 140.

67. Jordan, “Hospitals,” p. 142; General
Orders, 29 Dec 1776, Fitzpatrick, Washington,
6: 453-54.

68. Butterfield, Letters of Rush, 1: 121n,
2: 1198; Rush to Lee, 14 Jan 1777, 1: 125,
129; Bell, Morgan, p. 208; Corner, Rush, pp.
128, 130; Hawke, Rush, pp. 178-79.

69. Morgan, Vindication, pp. 16, 17, 160;
Griffenhagen, Drug Supplies, p. 117; Morgan
to Rush, 20 Oct 1776, Morgan, Vindication,
pp. 142-43.

70. Morgan, Vindication, pp. 17, 18; Gen-
eral Orders, 31 Oct 1776, Fitzpatrick, Wash-
ington, 6: 235.

71. Morgan, Vindication, pp. XXXvi—-Xxxxvii,
19.

72. Morgan, Vindication, pp. 136, 137;
William Eustis to General Heath, 10 Dec
1776, Force, American Archives, Sth ser. 3:
1161-62.

73. Morgan, Vindication, pp. xxiv, 133-34,
136, 137; Griffenhagen, Drug Supplies, p. 116.

74. Quote from James Tilton, Economical
Observations on Military Hospitals and the
Prevention and Cure of Diseases Incident to
an Army . . . (Wilmington, Del.: J. Wilson.
Notes to Chapter 4

1813), p. 33; Morgan, Vindication, pp. 45,
129; Col Isaac Nicoll to John McKesson, 29
Sep 1776, and Gen Nathanael Greene to
President of Congress, 10 Oct 1776, Force,
American Archives, Sth ser. 2: 597, 973.

75. Morgan, Vindication, pp. xxxvii, 22,
121-23; General Orders, 5 Nov 1776, Fitz-
patrick, Washington, 6: 241; Ford, Journals
of the Continental Congress, 5: 568 (see also
Appendix C in this volume); Heath to Mor-
gan, 19 Nov 1776, and Morgan to Heath,
20 Nov 1776, Force, American Archives, Sth
ser. 5: 769, 781; William Heath, Heath's
Memoirs of the American War, ed. Rufus
Rockwell Wilson (New York: A. Wessels
Co., 1904), pp. 94-95.

76. General Orders, 14 Apr 1776, 19 Apr
1776, 20 May 1776, 26 May 1776, Fitzpat-
rick, Washington, 4: 477, 492; 5: 63, 82-83,
quote from p. 63; New York Provincial Coun-
cil Resolution, 26 May 1776, and New York
Provincial Congress, 24 May 1776, Force,
American Archives, 4th ser. 6: 635, 1330-31;
Heath, Memoirs, pp. 55, 74.

77. Council of Massachusetts to General
Artemas Ward, 9 Jul 1776, and Gov Jonathan
Trumbull to Washington, 4 Jul 1776, Gibson,
Otto, pp. 91-92, 99; Brig Gen William Thomp-
son to Washington, 2 Jun 1776, Sparks, Cor-
respondence, 1: 209; Maryland Council of
Safety to Lieutenant Bracco, 29 Jun 1776,
Force, American Archives, 4th ser. 6: 1130-
31.

78. Lee to Washington, 27 Feb 1777,
James Curtis Ballagh, ed., The Letters of
Richard Henry Lee, 2 vols. (New York: Da
Capo Press, 1970 reprint of 1911-14 ed.),
1: 266; William Williams to Jonathan Trum-
bull, Jr., 6 Nov 1776, Burnett, Letters, 2:
142; Washington to Ward, 11 Jul 1776, Fitz-
patrick, Washington, 5: 256.

79. Washington to Lt Col Robert Hanson
Harrison, and to Cochran, 20 Jan 1777, to
New York Legislature, and to Gov Nicholas
Cooke, 10 Feb 1777, Fitzpatrick, Washington,
7: 38, 44-45, 129-30, 131-32, quote from
Washington to Shippen, 28 Jan 1777, pp.
75-76; Lee to Patrick Henry, 7 Apr 1777 and
22 Apr 1777, Ballagh, Letters, 1: 269, 283;
Medical Committee to Washington, 13 Feb
1777, Burnett, Letters, 1: 250.

235

80. Gibson, “Role of Disease,” p. 125;
Ford, Journals of the Continental Congress,
7: 139-40; Washington to Shippen, 6 Jan
1777, and to President of Congress, 5 Feb
1777, Fitzpatrick, Washington, 6: 473; 7:
105.

81. Washington to Shippen, 1 Mar 1777,
and to Foster, 18 Apr 1777, Fitzpatrick,
Washington, 7: 220, 432.

82. Washington to Henry, 13 Apr 1777,
Fitzpatrick, Washington, 7: 409.

83. Ford, Journals of the Continental Con-
gress, 7: 317, quote from 292; Nathan G.
Goodman, Benjamin Rush, Physician and
Citizen, 1746-1813 (Philadelphia: Univer-
sity of Pennsylvania Press, 1934), p. 86.

84. Richard Henry Lee to Arthur Lee,
20 Apr 1777, Ballagh, Letters, 1: 279; Lynn
Montross, Rag, Tag and Bobtail: The Story
of the Continental Army, 1775-1783 (New
York: Harper & Bros., 1952), p. 184.

85. Corner, Rush, p. 131; Victor Leroy
Johnson, The Administraton of the American
Commissariat During the Revolutionary War
(Philadelphia, 1941), p. 69.

CHAPTER 4

1. Peter Shindel, 20 Oct 1845, in C. H.
Martin, “The Military Hospital at the Cloister
(Ephrata, Pa., 1777),” Lancaster County
(Pa.) Historical Society Papers 51 (1947):
127.

2. Gibson, Otto, p. 140; Isaac Foster to
Mary Foster, 31 Jul 1777, in Washington,
Library of Congress, Manuscript Division,
Papers of Isaac Foster, folder 1.

3. Duncan, Medical Men, p. 212. Duncan
also refers to an army report for 5 August
1777 and maintains that while it records
14,204 fit for duty from a total of 17,949, it
also lists 4,745 sick. It is not clear from the
text whether the faulty arithmetic should be
laid at the foot of the author or of his source.
Lesser contains no report for August 1777 for
Washington's army.

4. General Orders, 2, 3, 9, 16, 17 Jun, 19
Oct 1777, Fitzpatrick, Washington, 8: 171,
175, 210, 255, 256; 9: 404, quote from Wash-
ington to Philip Livingston, Elbridge Gerry,
and George Clymer, 19 Jul 1777, 8: 441. A
236

rather casual attitude was taken at this time
toward official designations. General Washing-
ton used here the term “Surgeon General,” by
which he obviously meant the Physician and
Surgeon General of the Army, Dr. John Coch-
ran, who supervised the work of the regimental
surgeons.

5. General Orders, 1, 9 Jul 1777, Washing-
ton to Maj Gen John Sullivan, 7 Jul 1777,
Fitzpatrick, Washington, 8: 328, 364, 365, 374;
Sullivan, Letters, 1: 404-5.

6. General Orders, 15, 16, 17 Jun, 4 Sep
1777, Fitzpatrick, Washington, 8: 251, 255,
256; 9: 178.

7. Quote from Rush to John Adams, 8 Aug
1777, Butterfield, Letters of Rush, 1: 153; J.
P. Muhlenberg, “Orderly Book of Gen. John
Peter Gabriel Muhlenberg, March 26-Decem-
ber 20, 1777,” Pennsylvania Magazine of His-
tory and Biography 34 (1910): 449.

8. Howard H. Peckham, ed., The Toll of
Independence: Engagements & Battle Casual-
ties of the American Revolution (Chicago:
University of Chicago Press, 1974), pp. 40,
41; John W. Jordan, “Continental Hospital Re-
turns,” Pennsylvania Magazine of History and
Biography 23 (1899): 36-38.

9. Unless otherwise indicated, material in
the balance of this chapter is based on Brown,
Medical Department; Duncan, Medical Men;
and Gibson, Otto. Also consulted for the pre-
ceding paragraph were: quote from Tilton,
Observations, p. 56; James E. Gibson, “John
Augustus Otto,” Historical Review of Berks
County 13 (1947): 15; Gibson, “Role of
Disease,” p. 125; General Orders, 12 Sep
1777, Fitzpatrick, Washington, 9: 209.

10. Corner, Rush, pp. 132-33; Washington
to William Howe, 13 Sep 1777, Fitzpatrick,
Washington, 9: 217; Butterfield, Letters of
Rush, 1: 157n; William Shippen, “Just Ac-
count of Dr. Alison’s Services to the Best of
My Remembrance, 15 Dec 1780,” in Philadel-
phia, Historical Society of Pennsylvania,
Manuscript Department, Society Miscellaneous
Collection, case 19, box 2.

11. Washington to Maj Gen Nathanael
Greene, 25 Nov 1777, to William Shippen, 12
Dec 1777, and to Brig Gen Lachlan McIntosh,
4 Apr 1778, Fitzpatrick, Washington, 10: 105,
150; 11: 208; Shippen, Just Account; Shippen
to John Ettwein, 19 Sep 1777, Jordan, “Hos-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

pitals,” pp. 144-45, 148; Joseph Mortimer
Levering, A History of Bethlehem, Pennsyl-
vania, 1741-1892, With Some Account of Its
Founders and Their Early Activity in Amer-
ica (Bethlehem, Pa.: Times Publishing Co.,
1903), p. 475; John Morgan, Gibson, Otto,
p. 283; Report of Brig Gen Lachlan McIntosh,
26 Apr 1778, RG 93, M246, roll 135, folder
3-1, item 10; George L. Heiges, “Letters Re-
lating to Colonial Military Hospitals in Lan-
caster County,” Lancaster County (Pa.) His-
torical Society Papers 52 (1948): 74. See
Appendix G for data on many of the hospitals
not discussed in detail in the text.

12. General Orders, 9 Dec 1777, Fitzpat-
rick, Washington, 10: 141-42; William Shippen
to Jonathan Potts, 14 Dec 1777, Potts Papers,
3: 383; Thomas Bond, Jr., to Col John Patten,
13 Dec 1777, in Philadelphia, Historical So-
ciety of Pennsylvania, Manuscript Department,
Autograph Collection, case 19, box 15; Helen
Burr Smith, “Surgeon Jonathan Potts Planned
Innoculation [sic] at the Winter Camp,” Picket
Post, April 1947, p. 20.

13. Gibson, “Role of Disease,” p. 125; Ben-
jamin Rush to William Shippen, 2 Dec 1777,
Maj Gen Nathanael Greene, 2 Dec 1777, Wil-
liam Duer, 13 Dec 1777, and Washington, 26
Dec 1777, Butterfield, Letters of Rush, 1:
168-69, 170, 175, 176, 180.

14. Jordan, “Hospitals,” pp. 145, 146-47,
150, quote from Shippen to John Ettwein, 19
Sep 1777, pp. 144-45; James A. Beck, Beth-
lehem and Its Military Hospital, An Address
Delivered at the Unveiling of a Tablet Erected
by the Pennsylvania Society of the Sons of the
Revolution June 19, 1897 . . . (printed by the
Society), pp. 9, 11, 13.

15. Quote from message of 22 Sep 1777,
Ballagh, Letters, 1: 324; Jordan, “Hospitals,”
pp. 146-47; Beck, Bethlehem, p. 13; Levering,
Bethlehem, pp. 465, 466, 474, 475.

16. William Shippen to Congress, Oct 1777,
Duncan, Medical Men, p. 220; Report of Brig
Gen Lachlan McIntosh, 27 Apr 1778, RG 93,
M246, roll 135, folder 3-1, item 11.

17. Samuel Stringer, report of 1 Apr 1777,
Shippen to Potts, 7 Jul 1777, Cutting to Potts,
16 Mar 1778, and Thomas Bond, Jr., to Jona-
than Potts, 17 May 1778, Potts Papers, 2: 156,
235; 4: 421, 468; General Orders, 14 Apr
1778, Fitzpatrick, Washington, 11: 260; Grif-
Notes to Chapter 4

fenhagen, Drug Supplies, pp. 122, 127; Wash-
ington, National Archives, War Department
Collection of Revolutionary War Records,
Record Group 93, Numbered Record Books,
1775-98, series 5, Microfilm Publication
M853, roll 12, pp. 18, 36; Nellie Protsman
Waldenmaier, Some of the Earliest Oaths of
Allegiance to the United States of America
(Lancaster, 1944), pp. 22, 23; Bayne-Jones,
Preventive Medicine, pp. 43-44. The relation-
ship and status of the two apothecaries at this
time are not clear. General Washington re-
ferred to Cutting as the Apothecary General of
the Middle Department and Cutting signed two
oaths of allegiance in this capacity in May
1778, but other records of later origin list
Cutting as Apothecary General of the Eastern
Department during this period.

18. Quote from James Craik to Jonathan
Potts, 26 Apr 1778, Gibson, Otto, p. 164;
Hatch, Administration, pp. 92-93.

19. General Orders, 12 Nov 1777, 28 Feb
1778, Washington to the Officers Visiting
Hospitals, January 1778, Washington to Col
George Gibson, 21 Feb 1778, Fitzpatrick,
Washington, 10: 47-48, 406, 495-96, 526;
George Weedon, Valley Forge Orderly Book
of General George Weedon of the Continental
Army Under Command of Gen. George Wash-
ington, in the Campaign of 1777-8 (New
York: New York Times & Arno Press, 1971
reprint of 1902 edition), p. 128; William Ship-
pen to President of Congress, 24 Nov 1777,
Duncan, Medical Men, p. 240; Ford, Journals
of the Continental Congress, 10: 23.

20. General Orders, 15 Jan, 22 Feb, 17
Apr, 29 Apr, and 12 Jun 1778, Fitzpatrick,
Washington, 10: 306, 499; 11: 270, 271, 319;
12: 50; William Bradford Reed, ed., Life and
Correspondence of Joseph Reed, 2 vols.
(Philadelphia: Lindsay and Blakiston, 1847),
1: 361; Johnson, American Commissariat, pp.
107-8; Risch, Quartermaster Support, p. 41;
Ephraim Blaine to Jonathan Potts, 2 May
1778, and James Craik to Jonathan Potts, 24
May 1778, Potts Papers, 4: 461, 471.

21. Griftenhagen, Drug Supplies, pp. 127,
128; Invoice of Medicines Delivered to John
Cochran, Esq., Surgeon and Physician Gen-
eral, for the Use of the Middle Department, 6
Feb 1778, Shippen to Potts, 24 Feb, Cutting to
Potts, 25 Mar, Craigie to Potts, 27 Mar, 4 Apr,

237

1 May 1778, Potts Papers, 3: 400; 4: 411,
428, 429, 437, 458.

22. William Browne to Potts, 11 Mar, and
Craigie to Potts, 1 May 1778, Potts Papers,
4: 419, 458; John D. Kendig, A Legendary
and Factual Review of the Times of Henry
William Stiegel and the Early Days of Man-
heim (n.p., 1957), p. 12; William Shainline
Middleton, “Medicine at Valley Forge,” An-
nals of Medical History 3d ser. 3 (1941); 481;
James Hutchinson, “Notes: Valley Forge,”
Pennsylvania Magazine of History and Biog-
raphy 39 (1915): 221.

23. Quote from James Craik (to Jonathan
Potts?), 15 May 1778, Gibson, Otto, p. 177,
J. B. Cutting to Jonathan Potts, 16 Apr 1778,
Gibson, Otto, p. 166; General Orders, 14 Apr
1778, Fitzpatrick, Washington, 11: 261.

24. Quote from Andrew Craigie to Jonathan
Potts, 1 May 1778, Potts Papers, 4: 458;
James Craik to Jonathan Potts, 26 Apr 1778,
Gibson, Otto, p. 164.

25. General Orders, 6 and 8 Jan 1778,
Fitzpatrick, Washington, 10: 272, quote from
p. 276; Hatch, Administration, pp. 92-93;
Baron de Kalb to Count de Broglio, 21 Dec
1777, and James Craik to Jonathan Potts, 26
Apr 1778, Gibson, Otto, pp. 150, 164; Gibson,
“Role of Disease,” p. 125; Reed, Joseph Reed,
1: 362; Alfred Hoyt Bill, Valley Forge: The
Making of an Army (New York: Harper &
Bros., 1952), p. 102.

26. Quote from John Laurens, The Army
Correspondence of Colonel John Laurens in
the Years 1777-8 . . . (New York: Bradford
Club, 1867), p. 135; William Bell to Jonathan
Potts, 22 Apr 1778, Potts Papers, 4: 447;
General Washington to Gov George Clinton,
12 Mar 1778, Fitzpatrick, Washington, 11: 68;
Worthington Chauncey Ford, ed., General
Orders Issued by Major-General Israel Putnam
When in Command of the Highlands in the
Summer and Fall of 1777 (Boston: Gregg
Press, 1972 reprint of 1893 edition), p. 28;
Richard Henry Lee to Arthur Lee, 30 Jun
1777, Ballagh, Letters, 1: 306; “A Whitemarsh
Orderly Book,” Pennsylvania Magazine of His-
tory and Biography 45 (1921): 217-18; Reed,
Joseph Reed, 1: 361, 362; Weedon, Valley
Forge, pp. 263-64; Albigence Waldo, “Valley
Forge, 1777-1778. Diary of Surgeon Albigence
Waldo, of the Connecticut Line,” Pennsyl-
238

vania Magazine of History and Biography 21
(1897): 321.

27. Ford, Journals of the Continental Con-
gress, 10: 1016; Blanton, Medicine, p. 252.

28. James Craik to Jonathan Potts, 22 Mar
1778, 26 Apr 1778, and Tilton to Potts, 8
May 1778, Gibson, Otro, pp. 164, 169-70,
quote from p. 162; Washington to Officer
Commanding at Alexandria, Virginia, 20 Mar
1778, and General Orders, 17 Apr 1778, Fitz-
patrick, Washington, 11: 116, 271; John Coch-
ran to Jonathan Potts, 22 Mar 1778, Gibson,
Otto, p. 162; Francis Lightfoot Lee to George
Weedon, 31 Mar 1778, Burnett, Letters, 3:
147; James Tilton to Jonathan Potts, 22 Apr
1778, Potts Papers, 4: 446.

29. Weedon, Valley Forge, p. 294; Fraser
Lewis, “Medicine in the Continental Army of
the Revolutionary War: 1775-1783,” Phila-
delphia Medicine 55 (1959): 257-58; Nor-
wood, “Medicine,” p. 399; Shippen, “Plan,”
pp. 174n, 176; Tilton, Observations, p. 16.

30. Waldo, “Valley Forge,” p. 316; Gen-
eral Orders, 9, 13 Jan 1778, Fitzpatrick,
Washington, 10: 284, 300; Edward W. Hock-
er, “Medical Men Deserve Tribute for Care of
Washington’s Men at Valley Forge Encamp-
ment,” Picket Post 16 (January 1947): 8;
Edward Hand, “Orderly Book of General Ed-
ward Hand, Valley Forge, January 1778,”
Pennsylvania Magazine of History and Biog-
raphy 41 (1917): 223.

31. James Craik to Potts, 26 Apr 1778, and
James Fallon to Potts, 22 Apr 1778, Potts
Papers, 4: 450, 462, quote from p. 450;
Waldo, “Valley Forge,” p. 316; General Or-
ders, 21 Jan 1778, Fitzpatrick, Washington,
10: 333; Weedon, Valley Forge, p. 204.

32. Hand, “Orderly Book,” p. 464; General
Orders, 29 Jan and 20 Apr 1778, Fitzpatrick,
Washington, 10: 403; 11: 281; Hocker, “Medi-
cal Men,” p. 9; Waldo, “Valley Forge,” p. 316.

33. General Orders, 26 Dec 1777, 22 Feb
1778, Washington’s Instructions to Officers
Sent to the Hospital, 28 Feb 1778, General
Orders, 25 and 26 May 1778, Fitzpatrick,
Washington, 10: 207, 499, 526-27; 11: 453,
455; Hand, “Orderly Book,” p. 200.

34. James Craik to Potts, 7 Apr and 2 May
1778, Gibson, Otto, pp. 162, 173, quote from
p.- 173; General Orders, 12 Jun 1778, Fitz-
patrick, Washington, 12: 50.

THE ARMY MEDICAL DEPARTMENT,

1775-18138

35. James Craik to Potts, 26 Apr 1778,
Gibson, Otto, p. 164; Middleton, “Valley
Forge,” p. 472.

36. Gibson, “Role of Disease,” p. 125;
James Sproat, “Extracts From the Journal of
Rev. James Sproat, Hospital Chaplain of the
Middle Department, 1778,” ed. John W. Jor-
dan, Pennsylvania Magazine of History and
Biography 27 (1903): 442; Cyrus T. Fox, ed.,
Reading and Berks County Pennsylvania, A
History, 3 vols. (New York: Lewis Historical
Publishing Co., 1925), 1: 166; Oaths of Al-
legiance, RG 93, M853, roll 12, book 165, pp.
52, 78.

37. Sproat, “Extracts,” p. 442.

38. James Craik to Potts, 15 May 1778,
Potts Papers, 4: 467.

39. Samuel Kennedy to Potts, 27 Apr 1778,
and James Fallon to Potts, 27 Apr 1778, Gib-
son, Otto, p. 165, quote from Fallon to Potts:
Sproat, “Extracts,” pp. 443, 444; Samuel Ken-
nedy to Potts, 22 Apr 1778, Potts Papers, 4:
454.

40. Quote from Bethlehem Diarist in Beck,
Bethlehem, p. 13; Levering, Bethlehem, p.
475; Jordan, “Hospitals,” pp. 147-48, 149,
150; John Ettwein, quoted in Raymond Wal-
ters, Bethlehem Long Ago and To-Day (Beth-
lehem, Pa.: Carey Printing Co., 1923), p. 52;
John Ettwein, quoted in Levering, Bethlehem,
p. 474; John Ettwein, “A Short Account of the
Disturbances in America and of the Brethren’s
Conduct and Suffering in This Connection,”
in Kenneth Gardiner Hamilton, John Ettwein
and the Moravian Church During the Revolu-
tionary Period (Bethlehem, Pa.: Times Pub-
lishing Co., 1940), p. 180.

41. Hamilton, Ettwein, pp. 180, 181.

42. Various authors chose differing points
during the course of the dispersal of the pa-
tients of the Bethlehem hospital as the official
date of its closing. James Sproat, Journal of
James Sproat D.D., 1753, 1757, 1778, 1779,
1780, 1782, 1783, 1784, 1786, held by the
Historical Society of Pennsylvania, AM1597,
1778, pp. 1-2, 3-14; Walters, Bethlehem, p. 48;
John Hill Martin, Historical Sketch of Bethle-
hem in Pennsylvania (New York: AMS Press,
1971 reprint of 1872 edition), p. 31; Bethle-
hem of Pennsylvania: The First One Hundred
Years, 1741 to 1841 (Bethlehem, Pa., 1968),
p. 100; Levering, Bethlehem, p. 482; Jordan,
Notes to Chapter 4

“Hospitals,” pp. 150, 151; John Taylor Ham-
ilton, A History of the Church Known as the
Moravian Church, or the Unitas Fratrum or
the Unity of the Brethren During the Eight-
eenth and Nineteenth Centuries, Transactions
of the Moravian Historical Society, vol. 6
(Bethlehem, Pa.: Times Publishing Co., 1900),
p. 252.

43. Specific information on the origins of
the Lititz pharmacopoeia is sparse. It is usually
credited to Brown, who was probably aided by
others. The first edition, dated 1778, was un-
signed and apparently written in the winter and
early spring of 1778, too late to have been
used at Valley Forge, although most of the
medicines mentioned therein were undoubtedly
familiar to the physicians caring for General
Washington’s men there. Hamilton, Ettwein,
pp. 184-85; Jordan, “Hospitals,” pp. 153-54;
Middleton, “Valley Forge,” pp. 480-81; Grif-
fenhagen, Drug Supplies, pp. 126-27; Lyman
F. Kebler, “Andrew Craigie, the First Apothe-
cary General of the United States,” Journal of
the American Pharmaceutical Association 17
(1928): 171; Heiges, “Letters,” p. 78; Champe
C. McCulloch, “The Scientific and Adminis-
trative Achievement of the Medical Corps of
the United States Army,” Scientific Monthly
1 (May 1917): 412; Herbert H. Beck, “The
Military Hospital at Lititz, 1777-1778,” Lan-
caster County Historical Society Papers 23
(1919): 57.

44. Sisters’ House Diary, Beck, “Lititz,”
pp- 7, 8, quote from p. 8; Jordan, “Hospitals,”
pp. 154, 155; Jordan, “Returns,” p. 41; Return
of the Sick and Wounded at Lititz Hospital
From Jan. 12 to 22, 1778, in Philadelphia,
Historical Society of Pennsylvania, Manuscript
Department, Alison Papers, Continental Hos-
pital Returns 1777-78; Samuel X. Radbill,
“Francis Alison Jr., a Surgeon of the Revolu-
tion,” Bulletin of the History of Medicine 9
(1941): 247-48; Middleton, “Valley Forge,”
p. 470.

45. Middleton, “Valley Forge,” p. 471; Mar-
tin, “Ephrata,” pp. 127, 128, 132; Report of
Brig Gen Lachlan McIntosh, 26 Apr 1778, RG
93, M246, roll 135, folder 3-1, item 10; “Mon-
ument at Ephrata to Brandywine Battle Vic-
tims,” Magazine of American History 30
(1902): 75.

46. Report of Brig Gen Lachlan McIntosh,

239

26 Apr 1778, RG 93, M246, roll 135, folder
3-1, item 10; Rev Peter Miller to William
Shippen, 15 Jul 1779, Gibson, Otto, p. 287;
Martin, “Ephrata,” p. 130.

47. Quote from report of Brig Gen Lachlan
McIntosh, 26 Apr 1778, RG 93, M246, roll
135, folder 3-1, item 10; Sproat, 21 Jun 1778,
Gibson, Otto, p. 329; RG 93, M246, roll 135,
folder 3-1, item 11.

48. Report of Brig Gen Lachlan McIntosh,
26 Apr 1778, RG 93, M246, roll 135, folder
3-1, item 10; A Return of the Soldiers in the
General Hospital at Reading March 30th
1778, Potts Papers 4: 433; Jordan, “Returns,”
pp. 38-39; Radbill, “Alison,” p. 249; Gibson,
“John Augustus,” p. 16; “Elijah Fisher's Jour-
nal While in the War for Independence and
Continued for Two Years After He Came to
Maine, 1775-1784,” Magazine of History, Ex-
tra No. 6, entry for 19 Dec 1777, p. 17.

49. Report of Brig Gen Lachlan McIntosh,
26 Apr 1778, RG 93, M246, roll 135, folder
3-1, item 10; Gibson, Otto, pp. 159-61; Wil-
liam Shippen to Potts, 24 Mar 1778, Potts
Papers, 4: 426; Sproat, “Extracts,” p. 441.

50. Jordan, “Hospitals,” pp. 155, 156, 157;
John Ettwein to George Washington, 25 Mar
1778, Sparks, Correspondence, 2: 92; Hamil-
ton, Ettwein, pp. 187-89; William Shippen to
Potts, 20 and 24 Mar 1778, Potts Papers, 4:
422, 426; Report of Brig Gen Lachlan Mcln-
tosh, 26 Apr 1778, RG 93, M246, roll 135,
folder 3-1, item 10; Washington to McIntosh,
4 Apr 1778, Fitzpatrick, Washington, 11:
206-8.

51. James Tilton to Potts, 8 May 1778, Gib-
son, Otto, p. 170; Tilton to Potts, 22 Apr
1778, Potts Papers, 4: 446; Washington to
Brig Gen William Smallwood, 25 Feb 1778,
Fitzpatrick, Washington, 10: 511, 513; Report
of Brig Gen Lachlan McIntosh, 26 Apr 1778,
RG 93, M246, roll 135, folder 3-1, item 10.

52. James Craik to Potts, 10 May 1778,
Gibson, Otto, p. 176.

53. General Orders, 14 and 27 May 1778,
Fitzpatrick, Washington, 11: 387, 463; Asa
B. Gardner, “The New York Continental
Line” Magazine of American History 7
(1881): 409-10.

54. General Orders, 30, 31 May, 1 and 29
Jun 1778, Fitzpatrick, Washington, 11: 487-
88, 497; 12: 4, 131.
240

55. William Shippen to Potts, 16 Jun 1778,
Potts Papers, 4: 477.

56. Quote from Samuel Adams to Richard
Henry Lee, 22 Jul 1777, in Richard H. Lee,
Memoir of the Life of Richard Henry Lee
and His Correspondence With the Most Dis-
tinguished Men in America and Europe . . . ,
2 vols. (Philadelphia: H. C. Carey and I. Lea,
1825), 2: 123; Samuel MacKenzie to Potts, 24
Aug 1777, Potts Papers, 3: 290; Col John
Banister to Col Theodorick Bland, Jr., 10 Jun
1777, in Theodorick Bland, The Bland Papers,
Being a Selection From the Manuscripts of
Colonel Theodorick Bland, Jr. . . . , ed. Charles
Campbell, 2 vols. (Petersburg, Va.: E. & J. C.
Ruffin, 1840-43), 1: 55; Henry Sewall, “Let-
ters,” Historical Magazine, 2d ser. 2 (1867):
7. 8

57. Maj Gen Philip Schuyler to Congress,
25 June 1777, in Philip John Schuyler, “Pro-
ceedings of a General Court Martial . . . ,”
Collections of the New York Historical So-
ciety for the Year 1879, p. 115.

58. Quote from Sewall, “Letters,” p. 7;
Gen Philip Schuyler to Congress, 25 Jun 1777,
Schuyler, “Court Martial,” p. 115; Lesser,
Sinews, pp. 48, 49. Lesser gives no figures for
June 1777 and no breakdown of figures for
Ticonderoga and Mount Independence.

59. Thacher, Journal, pp. 83-84, 86-87;
Walter Steiner, “Dr. James Thacher of Ply-
mouth, Mass., an Erudite Physician of Revolu-
tionary and Post-Revolutionary Fame,” Bulle-
tin of the Institute of the History of Medicine
1 (1933): 160.

60. Francis Hagan to Potts, 19, 21, 22 Aug
and 21 Sep 1777, Nicholas Scull to Potts, 22
Aug 1777, Potts Papers, 3: 281, 285, 286,
287.

61. Samuel MacKenzie to Potts, 27 Aug
1777, Potts Papers, 3: 298.

62. John Bartlett to Potts, 18, 19, 21, 22
Aug 1777, and A Return of the Number of
Sick in the Hospital Belonging to the Several
Regiments and Companies on the Ground at
New York City, 22 Aug 1777, Potts Papers,
3: 278, 280, 284, 288, 289.

63. Maj Gen Philip Schuyler to General
Washington, 14 and 28 Jul 1777, Schuyler,
“Court Martial,” pp. 167, 179; James Wilkin-
son, Memoirs of My Own Times, 3 vols.
(Philadelphia: Abraham Small, 1816), 1:

THE ARMY MEDICAL DEPARTMENT,

1775-1818

265; Return of the Men Who Died Since
March the 1st 1777, General Hospital North-
ern Department, 29 Aug 1777, Potts Papers,
3: 304.

64. Brig Gen Simon Fraser to Maj Gen
Horatio Gates, 1 Sep 1777, Sparks, Corre-
spondence, 2: 522-23, quote from Maj Gen
Horatio Gates to Brig Gen Simon Fraser, 2
Sep 1777, p. 523; Wilkinson, Memoirs, 1: 230;
James E. Gibson, “Captured Medical Men and
Army Hospitals of the American Revolution,”
Annals of Medical History, n.s. 10 (1938):
385; Return of 15 Aug 1777, Return of the
Men Who Died Since March the Ist 1777,
General Hospital, Northern Department, 29
Aug 1777, a List of the Sick and Wounded
of His Majesty's Troops Left in the Hospital
Near Stillwater October the 19th 1777, and
a General Return of the Persons of Different
Regts Dead in the General Hospl Since the
Ist of March 1777 to the 12th Day Nov.r
1777, Potts Papers, 3: 273, 304, 355, 373;
Thacher, Journal, pp. 103, 112; John Mc-
Namara Hayes to Potts, 12 and 15 Oct 1777,
Gibson, “Captured,” p. 385; Gibson, Otto,
p. 230.

The report in Lesser for October 1777 for
Gates’s forces, dated 16 October, indicates
that the sick rate in Gates’s army was 9 per-
cent as of that date. The accuracy of this
figure, however, must be questioned. In Gates’s
army of the summer of 1777, which was much
smaller than that of mid-October, the per-
centage of the total number of rank and file
which was under the care of physicians aver-
aged more than 23 percent, according to the
monthly reports for July and August in Lesser.
Since during the Revolution the number of pa-
tients in the autumn tended to be essentially
identical to or greater than that in the summer,
a drop of 14 percentage points from summer
to fall would have been most unusual; never-
theless, even the sickness rate among the men
of the five brigades which were with General
Gates during the entire period in question
actually dropped almost 15 points, according
to the Lesser figures. In absolute terms, further-
more, the number of men sick, despite marked
increases in size for three of the five brigades
in question, dropped by as much as half or
more from August to October, as reported in
Lesser. Thus, for example, while Nixon's
Notes to Chapter 4

brigade grew from 1,454 rank and file in Au-
gust 1777 to 1,481 in October, the number
of sick among the rank and file fell from 306
to 142.

A figure of 9 percent sick and wounded for
16 October, furthermore, for units which had
very recently seen action is not compatible with
a figure of 11 percent (see figures in text)
confined to the general hospital alone only
twelve days earlier, at which time it might be
estimated that another 11 percent might have
been under the care of regimental surgeons.
The number of sick and wounded in Gates’s
army on 4 October, therefore, might easily
have been as high as 22 percent of the total
number of rank and file. It would seem highly
unlikely that only 9 percent remained under
the care of surgeons less than two weeks
later.

65. John McNamara Hayes to Potts, 12, 15
Oct 1777, 10 Feb 1778, Potts Papers, 3: 360,
363, 402; Thacher, Journal, p. 110.

66. Thacher, Journal, p. 103, quote from
p. 103; Wilkinson, Memoirs, 1: 323; James
Ripley Jacobs, Tarnished Warrior, Major-
General James Wilkinson (New York: Mac-
millan Co., 1938), pp. 70-276 passim, 296.

67. Thacher, Journal, pp. 112, 113-14,
quote from p. 112.

68. Malachi Treat to Potts, 20 Oct 1777,
A Return of the Patients Now in the Gen.
Hosp. Who Have Been Examined by the
Prescribing Physicians and Recommended for
Furlows Albany November 13th 1777, A Gen-
eral Return of the Wounded in the Gen.
Hospital at Albany in the Service of the
United States, 14 Nov 1777, A Return of the
Sick in Gen. Hospital Albany Novr 14th 1777,
A General Return of the Sick and Wounded
in the General Hospitals at Albany and
Schenectady December 16th 1777, and Andrew
Downe to Potts, 27 Dec 1777, Potts Papers,
3: 357, 374, 379, 380, 384, 389.

69. Dirk Van Ingen to Potts, 16 Aug 1777,
A Return of the Sick and Wounded Gen.
Hosp.l Schenactady [sic] Nov 10 1777, A
General Return of the Sick and Wounded in
the General Hospitals at Albany and Schenec-
tady December 16th 1777, A General Return
of the Sick and Wounded in the General Hos-
pital Northern Department Albany Febry 16th
1778, and Robert Johnston to Potts, 23 Feb

241

1778, Potts Papers, 4: 276, 371, 384, 407,
410.

70. A General Return of the Sick and
Wounded in the General Hospitals at Albany
and Schenectady December 16th 1777, Robert
Johnston to Potts, 22 Dec 1777, Malachi Treat
to Potts, 23 Dec 1777, A Return of the
Present State of the Generl Hospital N. De-
partment at Albany & Schenectady January
1778, and Robert Johnston to Potts, 15 Jan
1778, Potts Papers, 3: 384, 386, 387, 391,
394.

71. Thacher, Journal, p. 120; Shippen report
of 24 Nov 1777, Duncan, Medical Men, p.
239; Smith, “Potts,” p. 19; Robert Johnston,
Memorial to Congress, 31 May 1786, and
Malachi Treat, Statement, 30 May 1786, in
Washington, National Archives, Records of
the Continental and Confederation Congresses

and the Constitutional Convention, Record
Group 360, Papers of the Continental
Congress, 1774-1789, Microfilm Publication

M247, roll 38, items 129, 137.

72. Thacher, Journal, pp. 130-31, quote
from p. 121; Malachi Treat to Potts, 16 Feb
1778, A General Return of Sick, Wounded,
etc., in the General Hospital Northern Depart-
ment Albany March 16th 1778, Robert Johns-
ton to Potts, 19 Apr 1778, Samuel Stringer to
Potts, 20 Apr 1778, Potts Papers, 4: 405, 420,
442, 443, 470.

73. Thacher, Biography, p. 153; Joseph
Meredith Toner, The Medical Men of the
Revolution With a Brief History of the Medi-
cal Department of the Continental Army
(Philadelphia: Collins, 1876), p. 128; Gordon,
Aesculapius, p. 127; Ford, Putnam, p. 22;
Washington, National Archives, List of Officers
of the Medical Department U.S. Army 1775
to Present Date, Record Group 112, entry 84,
room 201. Shippen’s report of 24 Nov 1777,
Duncan, Medical Men, p. 239.

74. Charles B. Graves, “Dr. Philip Turner
of Norwich, Connecticut,” Annals of Medical
History 10 (1928): 5, 7, 8; Ford, Putnam,
pp. 55-56.

75. Quote from Isaac Foster, 2 Oct 1777,
Gibson, Otto, p. 286; Benjamin Rush to Wil-
liam Shippen, 2 Dec 1777, Butterfield, Letters
of Rush, 1: 170.

76. Quote from Isaac Foster to Mr. Bartlet,
21 Mar 1778, Foster Papers, folder 1; Ford,
242

Putnam, p. 21; S. Tenney to Peter Turner, 22
Mar 1778, in Washington, Library of Congress,
Manuscript Division, Papers of Peter Turner,
1778-1812.

CHAPTER 5

1. Unless otherwise indicated, passages con-
cerning military operations in this chapter are
based on the following: Maurice Matloff, ed.,
American Military History (Washington: Gov-
ernment Printing Office, 1969); Spaulding,
Army; Christopher Ward, The War of the
Revolution, ed. John R. Alden, 2 vols. (New
York: Macmillan Co., 1952; and Weigley,
Army.

2. Unless otherwise indicated, material con-
cerning the Hospital Department in this chap-
ter is based on Brown, Medical Department;
Duncan, Medical Men; and Gibson, Otto. The
preceding paragraph is also based on the fol-
lowing volumes: Quote from Henry Dearborn,
Journals of Henry Dearborn 1776-1783
(Cambridge: John Wilson and Son, 1887), p.
18; Charles Albert Moré, Chevalier de Pont-
gibaud, A French Volunteer of the War of
Independence, trans. and ed. Robert B. Doug-
las (New York: Benjamin Bloom, 1972), p.
56; George Otto Trevelyan, Saratoga and
Brandywine, Valley Forge, England and
France at War, The American Revolution, vol.
4 (London: Longmans, Green and Co., 1929),
p. 379; General Orders, 6 and 12 Jul 1778,
Fitzpatrick, Washington, 12: 160-61, 172;
James Craik to Jonathan Potts, 29 Jul 1778,
Potts Papers, 4: 479.

3. James Craik to Jonathan Potts, 29 Jul
1778, Potts Papers, 4: 479; General Orders, 7
Aug 1778, Fitzpatrick, Washington, 12: 289;
A Return of the Sick and Wounded in the
Army of the United States Commanded by His
Excellency General Washington on September
7, 1778, and Weekly Return of the Sick of the
Army of the United States, Commanded by
His Excellency General Washington—White
Plains August 24, 1778, RG 93, M246, roll
135, folders 3-3, items 54, 55.

4. General Orders, 12 and 13 Sep 1778,
and Washington to President of Congress, 4
Dec 1778, Fitzpatrick, Washington, 12: 430,
447; 13: 361; RG 93, M246, roll 135, folder
3-3, items 54, 5s.

5. Quote from Washington to Dr. James

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Tillotson, 26 Jul 1778, Fitzpatrick, Washing-
ton, 12: 235, James Craik to Jonathan Potts,
29 Jul 1778, Potts Papers, 4: 479.

6. Peter Angelakos, “The Army at Middle-
brook 1778-1779,” New Jersey Historical
Society Proceedings 70 (1952): 98, 99-100,
112, 116-17, and Barnabas Binney to Gen
Nathanael Greene, 18 May 1779, p. 117;
General Orders, 10 Mar and 8 Apr 1779,
Fitzpatrick, Washington, 14: 223, 347.

7. General Orders, 11 Feb 1779, Fitz-
patrick, Washington, 14: 100-101, quote from
p. 101; Angelakos, “Middlebrook,” pp. 105,
107; Bayne-Jones, Preventive Medicine, pp.
53-54, 58-59.

8. Returns of the Sick in Camp Commanded
by His Excellency General Washington, 13
Jul 1779, 2 Aug 1779, 10 Aug 1779, RG 93,
M246, roll 135, folder 3-1, items 30, 31, 32;
Weekly Return of the Sick in the Army of the
United States, Comanded [sic] by His Excelly
Genrl Washington, 4 Oct 1779, RG 93, M246,
roll 135, folder 3-3, item 61; Angelakos,
“Middlebrook,” p. 96; General Washington to
General Knox, Jun 1779, Fitzpatrick, Wash-
ington, 15: 214n. ;

9. Theodore G. Thayer, “The War in New
Jersey; Battles, Alarums, and the Men of the
Revolution,” New Jersey Historical Society
Proceedings, n. s. 71 (1953): 106; Ricardo
Torres-Reyes, Morristown National Historical
Park: 1779-1780 Encampment: A Study of
Medical Services (Washington: Office of His-
tory and Historic Architecture, Eastern Serv-
ice Center, April 1971), pp. 4-5; Don Higgin-
botham, The War of American Independence,
Military Attitudes, Policies, and Practice,
1763-1789 (New York: Macmillan Co.,
1971), p. 356.

10. Unless otherwise indicated, the section
concerning Morristown is based on Torres-
Reyes, Study. The preceding paragraph also
contains material from Thayer, “New Jersey,”
pp- 99, 106; Thacher, Journal, pp. 176-77;
Journal of Lt Charles Nukerck, in Frederick
Cook, ed., Journals of the Military Expedition
of Major General John Sullivan Against the
Six Nations of Indians in 1779 With Records
of Centennial Celebrations (Auburn, N.Y.:
Knapp, Peck & Thompson, 1887), p. 221.

11. Journal of Rudolphus Van Hovenburgh,
Cook, Journals, p. 284; S. Sydney Bradford,
Notes to Chapter 5

“Hunger Menaces the Revolution rw 0
Maryland Historical Magazine 61 (1966):
5-6; Risch, Quartermaster Support, p. 57;
Thacher, Journal, p. 181; Reed, Joseph Reed,
2: 191.

12. Lesser, Sinews, pp. 152-53; RG 93,
M246, roll 135, folder 3-1, item 2; Torres-
Reyes, Study, pp. 8-9, 28-30, 81, 82-84. The
figures given by Lesser do not entirely agree
with those of Torres-Reyes. The reader should
also note that Torres-Reyes concludes that only
416 men at Morristown were sick in February
on the basis of a return which, he states, deals
with the number of men sick in hospitals and
therefore, of course, does not deal with those
sick in their own tents. The nature of the re-
turns from this period makes this type of
error all too easy. Torres-Reyes also uses the
fit-for-duty figure as if it constituted the total
enrollment and on this basis gives 3.7 percent
as the proportion of the army at Morristown
which was sick.

Torres-Reyes does point out that although
a reconstruction of a Tilton hut was erected
at Jockey Hollow in the 1930's, later investi-
gation has revealed that there was no evidence
that as large a building as a Tilton hospital
was ever erected there. Tilton himself was
stationed at Basking Ridge in the winter of
1779-80, and a reference dated February
1780 has been located which mentions that a
hospital was built there for Tilton.

13. Journal of Lt William McKendry, Cook,
Journals, p. 211; Heath, Memoirs, p. 240.

14. James Craik, “A Letter Written by Jas.
Craik to Andrew Craigie, Esq., Apy. Genl.,
August 1780, Relating to the Condition of the
Army, Communicated by Nathaniel Paine,”
Massachusetts Historical Society Proceedings,
2d ser. 15 (1901-2): 363.

15. Dr. William Eustis called the unit at
Robinson’s House a flying hospital (Eustis to
Benedict Arnold, 7 Aug 1780, Washington
Papers, 4: 69). John Mathews to Medical
Committee, 10 Aug 1780, Burnett, Letters, 5:
320-21.

16. Shippen to Washington, 4 Jan 1781,
Washington Papers, 4: 73.

17. Reports of Mar, May, and Jun 1781,
Cochran Letter Book.

18. General Orders, 20 Jun 1781,
patrick, Washington, 22: 238.

Fitz-

243

19. Reports of Jul, Aug, and Oct 1781,
quote from Aug 1781, Cochran Letter Book.

20. Thomas Coffin Amory, The Military
Services and Public Life of Major-General
John Sullivan of the American Revolutionary
Army (Port Washington, N.Y.: Kennikat
Press, 1968 reprint of 1868 ed.), p. 152; R. W.
Vail, ed., The Revolutionary Diary of Lieut.
Obadiah Gore, Jr. (New York: The New York
Public Library, 1929), p. 20n; Order Book of
Lt Col Francis Barber, pp. 7, 8, in Louise
Wells Murray, ed., Notes From Craft Collec-
tion in Tioga Point Museum on the Sullivan
Expedition of 1779 and Its Centennial Cele-
bration of 1879, . .. (Athens, Pa.: 1929).

21. Quote from Orderly Book, 19 Jun-30
Jul 1779, Pennsylvania Archives, 6th ser. 14:
33; Shippen, Just Account; Journal of Lt John
L. Hardenburg, Cook, Journals, p. 122; Order
Book of Lt Col Francis Barber, p. 25, Murray,
Notes.

22. Journal of Lt William McKendry, Cook,
Journals, p. 200.

23. Quote from Journal of Rudolphus Van
Hovenburgh, Cook, Journals, p. 276; “Order
of March of Hand's Brigade From Wyoming
to Tioga,” Pennsylvania Archives, 6th ser. 14:
112, 115, 116.

24. Orderly Book, 19 Jun 1779, p. 52;
“Order of March,” p. 76; Order Book of Lt
Col Francis Barber, p. 63, Murray, Notes.

25. Order Book of Lt Col Francis Barber,
p. 78, Murray, Notes; Journal of Sgt Maj
George Grant, Cook, Journals, p. 110; Jabez
Campfield, “Diary of Dr. Jabez Campfield,
Surgeon in ‘Spencer’s Regiment,” While At-
tached to Sullivan’s Expedition Against the
Indians From May 23d to Oct 2d, 1779,”
New Jersey Historical Society Proceedings,
2d ser. 3 (1873): 121.

26. James Clinton to George Clinton, 30
Aug 1779, in Henry Steele Commager and
Richard B. Morris, eds., The Spirit of Seventy-
Six: The Story of the American Revolution As
Told by Participants (New York: Harper &
Row, 1967), p. 1016; Journals of James Nor-
ris, George Grant, Moses Fellows, Gookin,
Van Hovenburgh, McKendry, Adam Hubley,
Burrowes, and Erkuries Beatty, Cook, Jour-
nals, pp. 30, 34, 43, 47, 89, 106, 110, 160,
166, 233-34, 270; Journal of Lt Robert
Parker, in New York (State) University, Divi-
244

sion of Archives and History, The Sullivan-
Clinton Campaign in 1779. Chronology and
Selected Documents (Albany: The University
of the State of New York, 1929), p. 202;
“Order of March,” p. 100.

27. “Order of March,” pp. 112, 115, 116.

28. Journal of James Norris, Cook, Jour-
nals, p. 237; Albert Hazen Wright, The Sulli-
van Expedition of 1779, The Losses, Studies
in History No. 33 of New York Historical
Source Studies (1965), pp. 2-21, 28-29.

29. Quote from Dr. James Fallon to Dr.
Thomas Burke, 1 Apr 1779, in North Caro-
lina, The State Records of North Carolina, 26
vols. (Goldsboro, N.C.: Nash Brothers, 1886—
1907), 14: 50; William Shippen to General
Washington, 5 Oct 1778, Washington Papers,
4: 32.

30. Sproat, “Extracts,” pp. 444, 445; Jor-
dan, “Hospitals,” p. 157; Hamilton, Moravian
Church, p. 252; Hamilton, Ettwein, p. 185;
Sisters’ House Diary, Beck, Medicine, p. 12;
Return of Stores on Hand in Reading General
Hospital the First Day of May 1779, and
Thomas Bond, Jr., to Potts, 16 Aug 1781,
Potts Papers, 4: 504, 517.

31. Bodo Otto to Medical Committee, 19
May 1780, Gibson, Otto, pp. 181, 182, 183,
quote from Journal of the Rev. Dr. James
Sproat, p. 333; Bodo Otto to Charles Picker-
ing, 26 Aug 1780, RG 93, M859, roll 80;
John Cochran to Thomas Bond, 1 Oct 1781,
Cochran Letter Book; William Brown to Gen-
eral Washington, 3 Jul 1780, Washington
Papers, 4: 67; Gibson, “John Augustus,” p.
16; Sproat, “Extracts,” p. 445.

32. Quotes from William Brown to Gen-
eral Washington, 3 Jul 1780, Washington
Papers, 4: 67; Reports of Aug and Sep 1782,
Cochran Letter Book.

33. Sproat, “Extracts,” p. 445; Thomas
George Morton and Frank Woodbury, His-
tory of the Pennsylvania Hospital 1751-1895
(New York: Arno Press, 1973 reprint of 1895
edition), pp. 60, 61; Francis Randolph Pack-
ard, Some Account of the Pennsylvania Hos-
pital, From Its First Rise to the Beginning of
the Year 1938 (Philadelphia: Lea & Febiger,
1938), pp. 72, 73; Francis Randolph Packard,
History of Medicine in the United States
(New York: Paul B. Hoeber, 1931), pp. 570,
572, 573.

THE ARMY MEDICAL DEPARTMENT,

1775-1818

34. Minutes of Board Meeting, Morton and
Woodbury, History, pp. 61-62.

35. Quote from Minutes of Board Meet-
ing, Packard, History, pp. 574-75; Morton
and Woodbury, History, p. 62; Packard, Hos-
pital, pp. 74-75; A General Return of the Sick
& Wounded in G. Hospitals of the United
States, 6 Oct 1779, A General Return of the
Sick and Wounded in the Several Hospitals,
Belonging to the Army, Commanded by His
Excellency General Washington From March
1 to April 1 1780, and A General Return of
the Sick and Wounded in the General Hospital
Belonging to the Army Under Command of
His Excellency General Washington From
April 1 to May 1 1778, RG 93, M246, roll
135, folder 3-1, items 2, 3, 12; Shippen Re-
port of 31 Dec 1779, Gibson, Otto, p. 180;
Chard, “Cochran,” p. 374; Thornton Chard,
“Illustrations Pertaining to the Medical Life of
Doctor John Cochran,” Bulletin of the History
of Medicine 20 (1946): 83; Reports of Feb
and Mar 1781, Cochran Letter Book.

36. Reports of Jul, Sep, Oct 1781, Cochran
Letter Book; Ford, Journals of the Continen-
tal Congress, 14: 99.

37. C. Weisenthal to Potts, 6 Sep 1778,
Potts Papers, 4: 486.

38. Gibbes, R. W., ed., Reminiscences,
Documentary History of the American Revo-
lution . . ., 3 vols. (New York: D. Appleton
& Co., 1853-57), 2: 259-60, 263; Angelakos,
“Middlebrook,” pp. 116-17; General Orders,
10 Mar 1779, Fitzpatrick, Washington, 14:
223; Shippen Report of 31 Dec 1779, Gibson,
Otto, p. 180; A General Return of the Sick
and Wounded in the Several Hospitals, Be-
longing to the Army, Commanded by His
Excellency General Washington From March
1 to April 1 1780, and From April 1 to May
1780, RG 93, M246, roll 135, folder 3-1,
items 2, 3.

39. A Return of the Sick and Wounded in
the Gen Hospital at Sunbury From the 31
July to the 22 of Sept 1779, Weekly Returns
of 1 Oct, 11-18 Oct, 1-7 Nov, 7-13 Dec
1779, 7 Feb-13 Mar, 17 Apr 1780, Alison
Papers; “Order of March,” p. 112; Beatty,
Cook, Journals, p. 35; Weekly Returns of 10—
17 Jan, 24-31 Jan, 7-14 Feb, 21-28 Feb. 28
Feb-6 Mar, 6-13 Mar 1780, Jordan, “Re-
turns,” pp. 217-19.
Notes to Chapter 5

40. Quote from Jordan, “Returns,” p. 210;
Returns of 11-18 Oct, 1-7 Nov 1779, Alison
Papers.

41. Report of 17 Apr 1780, Alison Papers;
“Order of March,” p. 115.

42. Angelakos, “Middlebrook,” pp. 102-3,
104-5; General Washington to Director of the
Military Hospitals, 3 Jun 1779, and to James
Craik, 25 Jun 1779, Fitzpatrick, Washington,
15: 220-21, 318; RG 93, M246, roll 135,
folder 3-1, item 12.

43. RG 93, M246, roll 135, folder 3-1,
items 2, 3; Shippen Report, 31 Dec 1779, Gib-
son, Otto, p. 180; Eliza Susan Quincy, “Bask-
ing Ridge in Revolutionary Days. Reprinted
From Her Memoirs,” The Somerset County
Historical Quarterly 1 (1912): 35. There is
some question about the location of the hos-
pital, since Quincy gives the date of this hos-
pital as 1776, a year when there is no other
evidence to indicate that there was a hospital at
Basking Ridge. She was, however, by her own
account, an infant when the Revolution began
and for this part of her story was relying upon
the recollections of her mother, who was in
her eighties at the time of the writing. The
author describes Dr. James Tilton as “director
of the medical department” when the hospital
was located at Basking Ridge, but in 1776,
Tilton was a regimental surgeon in New
York; Trenton, New Jersey; and Wilmington,
Delaware. (Eliza Susan Morton Quincy,
Memoirs [Boston: John Wilson and Son,
1861], introduction and p. 17; Phalen, Chiefs,
pp. 22-23.) Thus it seems likely that the
older woman’s memory had misled her con-
cerning the date.

44. General Washington through Harrison
to Capt William Reily, 21 May 1780, Fitz-
patrick, Washington, 18: 401n.

45. Quotations from Malachi Treat to Gen-
eral Washington, 27 Jan 1781, Washington
Papers, 4: 74; Reports of Mar, May, and Jun
1781, Cochran Letter Book; James Tilton to
Timothy Pickering, 3 Oct 1780, RG 93, M859,
roll 88, item 25616; General Greene to James
Tilton, 27 Sep 1780, in George Washington
Greene, The Life of Nathanael Greene, 3 vols.
(New York: G. P. Putnam and Son, 1867-
1871), 2: 229-30.

46. Ford, Journals of the Continental Con-
gress, 11: 787-88; Burnett, Letters, 4: 249n;

245

General Washington to Philip Turner, 24 Feb
1780, Fitzpatrick, Washington, 18: 49-50;
Jabez Hatch to Timothy Pickering, 21 Dec
1780, and Isaac Foster to Timothy Pickering,
21 Dec 1780, RG 93, M859, rolls 82, 85,
items 23733, 24798; RG 93, M246, roll 135,
folder 3-1, items 1, 2, 3.

47. RG 93, M246, roll 135, folder 3-1,
items 1, 2, 3, and A Return of the Sick and
Wounded in the Military Hospital Eastern De-
partment, item 14; Isaac Foster to Mr. Pea-
body, 11 Mar 1780, RG 93, M859, roll 11,
item 3610; General Washington to James Wil-
kinson, 6 Dec 1779, Fitzpatrick, Washington,
17: 221; Thacher, Journal, p. 152.

48. Reports of Mar, May, and Jun 1781,
and John Cochran to Thomas Bond, 5 Jul
1781, Cochran Letter Book.

49. Thacher, Journal, p. 131; Shippen, Just
Account; Radbill, “Alison,” p. 249; General
Washington to trustees of church at New
Windsor, 31 Jul 1779, Fitzpatrick, Washing-
ton, 16: 25; RG 93, M246, roll 135, folder
3-1, item 12; A Return of the Sick Sent From
Robinson’s House to New Windsor, 20 Oct
1778, Alison Papers.

50. A flying hospital and a general hospital
could, of course, have shared the same facili-
ties, but this confusion is, perhaps, more likely
the result of the casual use of terms common
at this time. William Eustis to Benedict Arnold,
7 Aug 1780, Washington Papers 4: 69; Chard,
“Cochran,” p. 374.

51. Return of 20 Oct 1778, Alison Papers;
Chard, “Cochran,” p. 374; William Eustis to
Benedict Arnold, 7 Aug 1780, Washington
Papers, 4: 69; Fisher, “Journal,” pp. 38-39.

52. John Cochran to Colonel Hay, 10 Jul
1781, and to Thomas Bond, 5 Jul 1781,
Cochran Letter Book.

53. Reports of May-Oct 1781, Cochran
Letter Book.

54. RG 93, M246, roll 135, folder 3-1,
item 12; The American Revolution 1775-
1783: An Atlas of 18th Century Maps and
Charts: Theaters of Operations (Washington:
Government Printing Office, 1972), 139D.

55. General Washington to Dr. William
Shippen, 9 Sep 1778, Fitzpatrick, Washington,
12: 418; Graves, “Turner,” pp. 8, 11; RG 93,
M246, roll 135, folder 3-1, item 14.
246

56. Isaac Foster to Mr. Peabody, 4 Mar
1780, RG 93, M859, roll 11, item 3610; RG
93, M246, roll 135, items 1, 2, 3, 13; Coch-
rane, “Medical Department,” pp. 250-51;
General Washington to John Berrien, 25 Feb
1781, Fitzpatrick, Washington, 21: 292.

57. While no state was mentioned in this
return, General Washington ordered Bedford
patients moved east to Danbury, which rules
out Bedford, Massachusetts, east of Danbury;
Bedford, Pennsylvania, is too far away and in
the Middle Department (General Washington
to Dr. William Shippen, 9 Sep 1778, Fitz-
patrick, Washington, 12: 418). William Eustis,
26 Aug 1780, in Edward Warren, The Life of
John Warren, M.D. . . . (Boston: Noyes,
Holmes, & Co., 1874), pp. 187-88 (Edward
Warren's assumption that Eustis’s hospital
was in Pennsylvania is obviously incorrect.
The context of the letter makes it clear that
the hospital was in the Eastern Department).
RG 93, M246, roll 135, folder 3-1, item 14.

58. RG 93, M246, roll 135, folder 3-1,
item 14; General Washington to Dr. William
Shippen, 9 Sep 1778, Fitzpatrick, Washington,
12: 418.

59. Turner to Dr. Timothy Hosmer, 16 Nov
1778, and to William Shippen, 15 Mar 1779,
Graves, “Turner,” pp. 7, 11; RG 93, M246,
roll 135, folder 3-1, item 14; Ford, Journals
of the Continental Congress, 17: 447; Philip
Turner to Hooker, 29 Aug 1780, RG 93,
M3859, roll 121, item 034827; John Cochran
to Peter Turner, 25 Mar 1781, Cochran Letter
Book; Thacher, Journal, p. 163.

60. Packard, History, p. 600; Norwood,
Medical Education, p. 43; John Warren to
Governor and Council of Massachusetts, n.d.,
Warren, John Warren, pp. 193-94; John
Cochran to Robert Morris, 26 Jul 1781, Chard,
“Cochran,” p. 372; John Cochran to Samuel
Huntington, 24 May 1781, Cochrane, “Medi-
cal Department,” p. 248; John Cochran to
Thomas Bond, 1 Oct 1781, Reports of Mar
and May 1781, Cochran Letter Book; RG 93,
M246, roll 135, folder 3-1, items 1, 2, 3, 12,
14.

61. Malachi Treat to Jonathan Potts, 7
May 1778 and 28 Jan 1779, Potts Papers, 4:
442, 498, quote from 498; Washington to Brig
Gen James Clinton, 19 Jan 1779, to Malachi
Treat, 19 Jan 1779, and to Lord Stirling, 26

THE ARMY MEDICAL DEPARTMENT,

1775-18138

Jan 1779, General Orders, 2 Feb 1779, Fitz-
patrick, Washington, 14: 23, 24, 25, 47, 67;
Angelakos, “Middlebrook,” p. 117; Thacher,
Journal, p. 130; Ford, Journals of the Conti-
nental Congress, 7: 254.

62. General Clinton to Mrs. Clinton, 13
Jun 1779, New York University, Documents,
p. 96.

63. RG 93, M246, roll 135, folder 3-1,
items 2, 7, 12; William Brown to General
Washington, 3 Jul 1780, Washington Papers,
4: 67; John Mathews to Medical Committee,
10 Aug 1780, Burnett, Letters, 5: 320-21.

64. Malachi Treat to Medical Committee,
21 Aug 1780, Potts Papers, 6: 519.

65. Reports of May-Oct 1781,
Letter Book, quote from May 1781.

66. Quote from John Cochran to Samuel
Huntington, 24 May 1781, Cochrane, ‘“Medi-
cal Department,” p. 248; Return of Medical
Department, 23 Jul 1781, Duncan, Medical
Men, pp. 344-45.

67. Sproat Journal, Gibson, Otro, p. 332;
General Washington to Malachi Treat, 19 Jan
1779, Washington Papers, 4: 55; Washington
to Brig Gen James Clinton, 19 Jan 1779, and
General Orders, 3 Feb 1781, Fitzpatrick,
Washington, 14: 23; 21: 174; Major Wylls to
Samuel Blachley Webb, 4 Apr 1781, in James
Watson Webb, ed., Reminiscences of Gen’l
Samuel B. Webb . . . , 2 vols. (New York:
privately printed, 1882), 2: 333; Heath,
Memoirs, p. 296; General Orders, Washing-
ton, 8 Jan 1782, RG 93, M853, roll 9, book
57, pp. 111-12; Thacher, Journal, pp. 250-51,
298.

68. General Washington to James Craik,
24 May 1780, Washington Papers, 4: 66;
Packard, History, pp. 590-91, 594; Lafayette
to Le Comte de Rochambeau, 19 May 1780,
in Marie Joseph Paul Yves Lafayette, Mé-
moires, correspondance, et manuscrits du
général Lafayette publiées par sa famille, 2
vols. (Brussels: Société belge de Librairie,
1837), 1: 117; Phalen, Chiefs, p. 19.

69. Hall, “Beginnings,” p. 123; William
Heath to Governor of Rhode Island, 18 Jun
1780, Packard, History, pp. 592-93; Maurice
Bouvet, Le Service de santé francais pendant
la guerre d'indépendance des Etats-Unis
(Paris: Hippocrate, 1933), pp. 31-32, 56,
58-60, 91; Craik to Washington, 21 Jun

Cochran
Notes to Chapter 5

1780, Washington Papers, 4: 67; Ludwig von
Closen, The Revolutionary Journal of Baron
Ludwig von Closen, 1780-1783, ed. Evelyn
M. Acomb (Chapel Hill: University of North
Carolina Press, 1958), pp. 28, 28n, 37; John
E. Lane, “Jean-Frangois Coste, Chief Physi-
cian of the French Expeditionary Forces in
the American Revolution,” Americana 22
(1928): 54-55; Packard, History, p. 594.

70. Unless otherwise indicated, material in
this chapter concerning the care of military
patients south of Virginia is based on Chal-
mers Gaston Davidson, Friend of the People:
The Life of Peter Fayssoux of Charleston
(Columbia, S.C.: South Carolina Medical As-
sociation, 1950). The preceding paragraph is
also based on Ford, Journals of the Continen-
tal Congress, 19: 292-94.

71. Quote from David Oliphant to Gen
William Moultrie, 18 Jul 1778, Davidson,
Fayssoux, p. 25; Benjamin Mather of the Of-
fice of Accounts, Hospital Department, 12
Oct 1786, RG 360, M247, roll 38, item 153.

72. Henry Lee, Memoirs of the War in the
Southern Department of the United States, 3d
ed., 2 vols. (Philadelphia: Bradford and Ins-
keep, 1812), 1: 139; Gibson, “Role of Dis-
ease,” p. 126; Hugh Williamson to Dr. Hay,
24 Aug 1780, to Major England, 30 Aug 1780,
to Hon Thomas Benbury, Aug and 1 Dec
1780, and Maj William R. Davie to Governor
Caswell, 29 Aug 1780, North Carolina, State
Records, 15: 61-62, 166-67, 370; Gibson,
“Captured,” pp. 388-89; Banastre Tarleton,
A History of the Campaigns of 1780 and
1781 in the Southern Provinces of North
America (London: T. Cadell, 1787), pp. 31-
32; David Hosack, 4 Biographical Memoir of
Hugh Williamson, M.D., LL.D. (New York:
C. S. Van Winkle, 1820), pp. 56, 57-60;
Henry Laurens to Benjamin Lincoln, 9 Oct
1779, Burnett, Letters, 4: 479-80; Col Charles
C. Pinckney to Moultrie, 1 Jul 1778, Council
of War at Camp at Fort Tonyn, 11 Jul 1778,
Moultrie to Lieutenant Colonel Balfour, 22
Nov 1780, David Oliphant to Moultrie, 14
Nov 1780, and Peter Fayssoux to David Ram-
say, 26 Mar 1785, in William Moultrie, Mem-
oirs of the American Revolution . . . , 2 vols.
(New York: New York Times & Arno Press,
1968 reprint of 1802 ed.), 1: 229, 235-36;
2: 112, 114, 142, 143, 398.

247

73. Quote from Horatio Gates to Director
of the Hospitals in the Southern Department,
Gates, “Letters,” p. 284, and Gates to Presi-
dent of Board of War, 20 Jul 1781, p. 288;
Lyman C. Draper, King’s Mountain and Its
Heroes: History of the Battle of King’s Moun-
tain, October 7th 1780, and the Events Which
Led to It (Cincinnati: P. G. Thomson, 1881),
p. 306; Joseph Graham, “Narrative of the
Revolutionary War in North Carolina in
1780 and 1781,” in Papers of Archibald D.
Murphey, ed. W. H. Hoyt, 3 vols. (Raleigh,
1914), 2: 231n; Surgeon Browne to Major
General Gates, 20 Aug 1780, and Gen R.
Caswell to Gov Abner Nash, 31 Jul 1780,
North Carolina, State Records, 14: 562; 15:
11. See also Table 1.

74. Quote from Nathanael Greene to Con-
tinental Congress, 28 Dec 1780, in Allen
Bowman, Morale of the American Revolu-
tionary Army (Washington: American Coun-
cil on Public Affairs, 1943); Graham, “Nar-
rative,” 2: 233, 234; Proceedings of the Board
of War, Hillsboro, N.C., 17 Nov 1780, North
Carolina, State Records, 14: 452.

75. Gen Nathanael Greene to Colonel Mar-
bury, 16 Dec 1780, North Carolina, State Rec-
ords, 15: 181; Theodore Thayer, Nathanael
Greene, Strategist of the American Revolu-
tion (New York: Twayne Publishers, 1960),
p- 294; Gibbes, Reminiscences, p. 274.

76. General Moultrie to Lieutenant Colonel
Balfour, 12 Feb 1781, Moultrie, Memoirs, 1:
159.

77. Maj John Armstrong to General Sum-
ter, 1 Jul 1781, and General Sumter to Lt
Col John B. Ashe, 14 Jul 1781, North Caro-
lina, State Records, 15: 505, 533; Ford,
Journals of the Continental Congress, 19: 292-
94; Norwood, “Medicine,” p. 399.

78. Quote from Dr. Robert Wharry to Dr.
Reading Beatty, 27 Jul 1781, in Joseph M.
Beatty, Jr., “Letters From Continental Offi-
cers to Doctor Reading Beatty, 1781-1788,”
Pennsylvania Magazine of History and Biog-
raphy 54 (1930): 161; Maj John Armstrong
to Gen Nathanael Greene, 1781, Greene,
Greene, 3: 347; Lee, Memoirs of the War, 2:
145.

79. Gen Stephen Drayton to General Sum-
ter, 29 Jun 1781, North Carolina, State Rec-
ords, 15: 497.
248

80. RG 360, M247, roll 30, item 22; Lee,
Memoirs of the War, 1: 94n; Gibbes, Remi-
niscences, pp. 279, 281.

81. Greene, Greene, 3: 407, 408, quote
from Greene to President of Congress, n.d.,
3: 407; Nathanael Greene, “Report on the
‘Battle of Eutaw Springs,” Magazine of His-
tory, Extra No. 3, pp. 8-10; Bowman,
Morale, p. 23.

82. Resolve of the Continental Congress, 25
May 1781, RG 360, M247, roll 30, item 22;
David Oliphant to General Moultrie, 7 May
1781, in David Ramsay, The History of the
Revolution in South-Carolina . . . , 2 vols.
(Trenton: Isaac Collins, 1785), 2: 526-27;
2: 288.

83. Blanton, Medicine, p. 273; Robert B.
Munford, Jr., “Military Hospital in Williams-
burg, 1777,” Virginia Magazine of History
30 (1922): 389-90.

84. Ford, Journals of the Continental Con-
gress, 7: 292, 317; 9: 1016; Blanton, Medi-
cine, pp. 252, 274; Goodman, Rush, p. 86.

85. A Return of the Sick & in Camp and
Fredericksburg and the Vicinity Under the
Command of His Excellency George Wash-
ington, Oct 25 1778, RG 93, M246, roll 135,
folder 3-1, item 29.

86. Quote from General Washington to
William Shippen, 10 Oct 1779, Washington
Papers, 4: 61; William Shippen to T. Bland,
27 Nov 1780, Duncan, Medical Men, p. 322;
General Washington to General Scott, 27
Jul 1779, and to William Brown, 22 Apr
1780, Fitzpatrick, Washington, 15: 492-93;
18: 291.

87. Report of Mar 1781, Cochran Letter
Book; William Rickman to Brig Gen John
Peter Gabriel Muhlenberg, 16 May 1780,
and William Brown to Washington, 3 Jul
1780, Washington Papers, 4: 66, 67; Bow-
man, Morale, p. 22.

88. Blanton, Medicine, pp. 248, 276; Wil-
liam O. Owen, ed., The Medical Department
of the United States Army. Legislative and
Administrative History . . . (New York: P.
B. Hoeber, 1920), pp. 164, 165; Commager
and Morris, Seventy-Six, p. 1230.

89. Blanton, Medicine, p. 8; Davidson,
Fayssoux, pp. 52, 53; Thomas Tudor Tucker
to Saint George Tucker, 27 Jul 1781, in Wil-
liamsburg, Va., The College of William and

THE ARMY MEDICAL DEPARTMENT,

1775-18138

Mary in Virginia, Earl Gregg Swem Library,
Special Collections Division, Tucker-Coleman
Papers, 1780-82, microfilm roll M-13.

90. Quote from John Davis, “The York-
town Campaign: Journal of Captain John
Davis, of the Pennsylvania Line,” Pennsyl-
vania Magazine of History and Biography 5
(1881): 293; Josiah Atkins, Diary and Let-
ters in Joseph Anderson, ed., The Town and
City of Waterbury, Connecticut, From the
Aboriginal Period to the Year Eighteen Hun-
dred and Ninety-Five, 2 vols. (New Haven:
Price & Lee Co., (1896), 1: 476; William
Feltman, “The Journal of Lieut. William
Feltman, of the First Pennsylvania Regiment,
From May 26, 1781, to April 25, 1782, Em-
bracing the Siege of Yorktown and the South-
ern Campaign,” Pennsylvania Historical So-
ciety Collection 1 (1853): 303-5.

91. Davis, Journal, p. 295; William Mc-
Dowell, “Journal of Lieut William McDowell
of the First Penna Regiment, in the Southern

Campaign 1781-1782," Pennsylvania Ar-
chives, 2d ser. 15: 301.
92. Atkins, Diary, Anderson, Waterbury,

pp. 476, 477, 478, 479; Bouvet, Service de
santé, pp. 83, 85; Feltman, “Journal,” p. 309.

93. Reports of Sep and Oct 1781, Cochran
Letter Book; Blanton, Medicine, pp. 275-76;
Bouvet, Service de santé, p. 88; Thacher,
Journal, pp. 281-82.

94. Bouvet, Service de santé, p. 94, and Jean-
Frangois Coste to Dr. Cornette, 3 Feb 1786,
p. 95; Ebenezer Denny, Military Journal of
Major Ebenezer Denny . . . (Philadelphia:
Historical Society of Pennsylvania, 1859), p.
39.

95. General Orders, 2 Oct 1781, and Wash-
ington to Jean-Francois Coste, 7 Oct 1782,
Fitzpatrick, Washington, 23: 168; 25: 244;
Bouvet, Service de santé, pp. 51, 96-97; Pack-
ard, History, p. 590; Hall, “Beginnings,” p.
123; General Gregory to Governor Burke, 22
Aug 1781, North Carolina, State Records, 15:
618, Blanton, Medicine, pp. 259, 275-76.

96. Blanton, Medicine, p. 275; Report of
Oct 1781, Cochran Letter Book; Thacher,
Journal, pp. 286, 293; Bouvet, Service de
santé, p. 97; James Craik to General Washing-
ton, 21 Sep 1781, Washington Papers, 4: 81.

97. Moré, French Volunteer, pp. 88-89.

98. General Washington to Col Stephen
Notes to Chapter 5

Moylan, 31 Oct 1781, Fitzpatrick, Washing-
ton, 23: 312; General Washington to Gen
Arthur St. Clair, 29 Oct 1781, in William
Henry Smith, ed., The St. Clair Papers. The
Life and Public Services of Arthur St. Clair
.. ., 2 vols. (Cincinnati: Robert Clarke & Co.,
1882), 1: 562; General Washington to James
Craik, 23 Oct 1781, Washington Papers 4:
81; Denny, Journal, p. 45; Blanton, Medicine,
p. 276; Heath, Memoirs, p. 340.

99. Reports for Nov and Dec, 1781, Coch-
ran Letter Book. Duncan suggests that Tilton
preceded Treat and that Tilton’s term of serv-
ice was quite brief (Duncan, Medical Men, p.
355), but on 2 January 1782, General Wash-
ington referred to Tilton as Treat’s successor
(General Washington to Lt Col Francis Ment-
ges, 2 Jan 1782, Fitzpatrick, Washington, 23:
423-24). A letter from Tilton to a friend
from Williamsburg is dated 16 December
1781 (Tilton, 16 Dec 1781, Thacher, Biog-
raphy, 2: 140), but one of General Washing-
ton’s correspondents wrote in a letter dated
29 November 1781 as if Treat were in charge
at Williamsburg at that time (Colonel Ment-
ges to General Washington, 29 Nov 1781,
Chard, “Cochran,” pp. 372-73). A logical as-
sumption would seem to be that Treat di-
rected the hospital at Williamsburg until some
time in early December 1781, at which time
he was succeeded by Tilton.

100. Washington to Rochambeau, 8 Jan
1782, and to Colonel Mentges, 1 Mar 1782,
Fitzpatrick, Washington, 23: 435; 24: 34;
Colonel Mentges to Washington, 29 Nov 1781,
Cochran to Tilton, 1 Jan 1782, and Report
of Jan 1782, Cochran Letter Book; Blanton,
Medicine, pp. 277, 283; Closen, Journal, p.
169; Quartermaster General Pickering to Vir-
ginia Governor Nelson, 8 Nov 1781, Duncan,
Medical Men, p. 355.

101. General Greene to General Washing-
ton, 25 Oct 1781, Sparks, Correspondence, 3:
430.

102. Quotes from Feltman, “Journal,” pp.
325, 326, 334; William Addleman Ganoe,
The History of the United States Army (New
York: D. Appleton and Co., 1924), p. 19.

103. Quote from Denny, Journal, p. 46;
John Bell Tilden, “Extracts From the Journal
of Lieutenant John Bell Tilden, Second Penn-

249

sylvania Line, 1781-82,” Pennsylvania Maga-
zine of History and Biography 19 (1895):
226; Doctor Wharry to Dr. Reading Beatty,
12 Mar 1782, Beatty, “Letters,” p. 166; Mc-
Dowell, “Journal,” pp. 312-20.

104. McDowell, “Journal,” p. 323.

105. McDowell, “Journal,” pp. 326-31,
quote from p. 328; Tilden, “Journal,” p. 227;
Greene, Greene, 3: 456; Denny, Journal, p. 47.

106. McDowell, “Journal,” pp. 329-31,
332, quote from p. 331.

107. Quote from General Wayne to Ben-
jamin Rush, 24 Dec 1782, in Charles J. Stille,
Major-General Anthony Wayne and the Penn-
sylvania Line in the Continental Army (Phila-
delphia: J. B. Lippincott Co., 1893), p. 301;
General Harmar to St. Clair, 29 Sep 1782,
Smith, St. Clair, 1: 569; Feltman, “Journals,”
p. 334.

108. Edward McGrady, The History of
South Carolina in the Revolution 1780-1783,
2 vols. (New York: Russell & Russell, 1969
reissue of 1902 publication), pp. 676, 701,
702; William Seymour, “Journal of the South-
ern Expedition, 1780-1783, by William Sey-
mour, Sergeant-Major of the Delaware Regi-
ment,” Pennsylvania Magazine of History and
Biography 7 (1883): 394.

109. Quote from Thacher, Journal, p. 281;
Heath, Memoirs, pp. 341-42, 343, 361; Re-
ports of Feb, May, and Jun, 1782, and Coch-
ran to Thomas Bond, 4 Dec 1781, Cochran
Letter Book.

110. General Washington to Pres John
Dickinson, 3 Dec 1781, Fitzpatrick, Washing-
ton, 23: 368-69; Report of Dec 1781 and
Cochran to Bond, 4 Dec 1781, Cochran Let-
ter Book; Ltr, Robert Morris to Thomas Bond,
19 Feb 1782, Library of Congress; Daniel
Shute, “The Journal of Dr. Daniel Shute, Sur-
geon in the Revolution 1781-1782," New
England Genealogical Register 84 (1930):
387, 388.

111. General Orders, 6 Sep and 14 Nov
1782, Fitzpatrick, Washington, 25: 132, 345;
Samuel Adams to General Heath, 9 Dec 1781,
RG 93, M859, roll 101, item 29275.

112. Reports of Dec 1781-Jul 1782, Coch-
ran Letter Book.

113. Reports of Aug, Sep, Nov, Dec 1782,
Cochran Letter Book.
250

114. Reports of Nov 1781, Feb and Mar
1782, Cochran Letter Book; General Wash-
ington to William Duer and Daniel Parker, 29
May 1783, Fitzpatrick, Washington, 26: 460;
Lists of Officers in the Mil. Hostls of the U.S.
Exclusive of the Southern Department, 12
Nov 1783, RG 93, M246, roll 135, folder 3-3,
item 59.

115. Reports of May-Jul, Sep, Nov, Dec
1782, Cochran Letter Book.

116. Quote from James Craik to Timothy
Pickering, 1 May 1782, RG 93, M3859, roll
95, item 27685; General Washington to Sec-
retary at War, 18 May 1782, Fitzpatrick,
Washington, 24: 263.

117. Quote from General Washington to
Maj Gen Henry Knox, 11 Nov 1782, Fitz-
patrick, Washington, 25: 330; William Eustis
to Timothy Pickering, 3 Oct and 11 Dec
1782, RG 93, M859, roll 81, items 23505,
23506; Bouvet, Service de santé, p. 84; Thach-
er, Journal, pp. 307, 324.

118. General Washington to Maj Gen Hen-
ry Knox, 11 Nov 1782, Fitzpatrick, Washing-
ton, 25: 330; Reports of Aug-Dec 1782,
Cochran Letter Book.

119. Reports of Nov and Dec 1781, Coch-
ran Letter Book.

120. Packard, History, p. 575; Reports of
Nov, Dec 1781, Jan-May 1782, and Cochran
to Bond, 4 Dec 1781, Cochran Letter Book.

121. Packard, History, p. 575; Reports of
Aug, Oct, Nov 1781, Jan, Feb, Jun-Sep, Nov,
Dec 1782, Cochran Letter Book.

122. Ford, Journals of the Continental
Congress, 25: 740; RG 93, M246, roll 135,
folder 3-3, item 59; Reports of Feb, Mar,
Nov 1781, May-Sep, Nov 1782, Cochran
Letter Book; Cochran to James Craik and to
John Warren, 10 Oct 1781, Chard, “Coch-
ran,” pp. 365, 372; Gibson, Otto, p. 314;
Cochran, Letters to Binney, 22 Oct 1781, p.
230.

123. General Washington to John Cochran,
18 Jun 1782, Fitzpatrick, Washington, 24:
357.

124. Quote from General Orders. 18 May
1782, Fitzpatrick, Washington, 24: 265; Ford,
Journals of the Continental Congress, 25: 740.

125. General Orders, 4 Aug 1782, Fitz-
patrick, Washington, 24: 464.

THE ARMY MEDICAL DEPARTMENT,

1775-1818

CHAPTER 6

1. Unless otherwise indicated, the sections of
this chapter concerning the U.S. Army’s
strength and organization are based on John
F. Callan, The Military Laws of the United
States Relating to the Army, Volunteers,
Militia, and to Bounty Lands and Pensions,
From the Foundation of the Government to
the Year 1863 (Philadelphia: George W.
Childs, 1863); and Weigley, Army. Also con-
sulted for the preceding paragraph was Leonard
D. White, The Federalists: A Study in Adminis-
trative History, 1789-1801 (New York: Mac-
millan Co., 1948), p. 236.

2. Harry M. Ward, The Department of War,
1781-1795 (Pittsburgh: University of Pitts-
burgh Press, 1962), p. 187.

3. Unless otherwise indicated, material in
this chapter relating to military campaigns is
based on Ganoe, U.S. Army; Spaulding, Army;
and Weigley, Army; while material describing
the work of Army surgeons is based on Brown,
Medical Department. The preceding paragraph
also contains material from Lurton Dunham
Ingersoll, A History of the War Department of
the United States, With Biographical Sketches
of the Secretaries (Washington: Francis D.
Mohun, 1880), p. 212.

4. U.S. Congress, American State Papers:
Documents, Legislative and Executive of the
Congress of the United States. Class V : Military
Affairs, 7 vols. (Washington: Gales and Seaton,
1832-61), 1: 147-51.

5. Quote from J. W. Daniels to Secretary of
War, 12 Feb 1810, in Washington, National
Archives, Records of the Office of the Secretary
of War, Record Group 107, Letters Received
by the Secretary of War, Main Series, 1801-
1870, Microfilm Publication M221, roll 36;
American State Papers: Military Affairs, 1:
209, and Henry Dearborn to House of Repre-
sentatives, 9 Dec 1807, 1: 225; Bernard De-
voto, ed., The Journals of Lewis and Clark
(Boston: Houghton Mifflin, 1953), pp. 489-91.

6. Washington to John Cochran, 10 Aug
and 4 Nov 1783, and Washington to Secretary
of War, 4 Nov 1783, Fitzpatrick, Washington,
27: 95, 230-31; Orderly Book RG 93, M853,
roll 9, book 60, pp. 112-15; Ford, Journals of
the Continental Congress, 25: 740; List of
Notes to Chapter 6

Officers in the Mil Hostls of the U.S. Exclusive
of the Southern Department, 12 Nov 1783, RG
93, M246, roll 135, folder 3-3, item 59.

7. Quote from Oliver Spencer, quoted by
Virginius Hall, Forman, Physicians; U.S. Con-
gress, Senate, Journal of the Executive Proceed-
ings of the Senate of the United States, 1789-
1901, 32 vols. (Washington: Govenment Print-
ing Office, 1828-1909), 1: 46-47.

8. Quote from Richard Allison to Brig Gen
J. Harmar, 16 Apr 1789, quoted by Virginius
C. Hall, “Richard Allison—Surgeon to the
Legion,” Foreman, Physicians; U.S. Congress,
Senate, Executive Proceedings, 1: 46-47; Josiah
Harmar, The Proceedings of a Court of In-
quiry, Held at the Special Request of Brigadier
General Josiah Harmar . (Philadelphia,
1791), p. 12.

9. U.S. Congress, Senate, Executive Proceed-
ings, 1: 84, 87; Winthrop Sargent, “Winthrop
Sargent’s Diary While With General Arthur St.
Clair’s Expedition Against the Indians,” Ohio
Archaeological and Historical Quarterly 33
(1924): 264, 268; Richard C. Knopf,
“Biographical Data,” Forman, Physicians;
Smith, St. Clair, 2: 200n, and Arthur St. Clair
to Secretary of War, 17 Nov 1791, 2: 267n;
Frazer E. Wilson, Arthur St. Clair (Richmond,
Va.: Garrett and Massie, 1944), p. 4. There is
some confusion concerning the position of
Victor Grasson. Brown and both Tobey and
Ashburn, who appear to lean heavily on Brown,
classify Grasson as a Regular Army surgeon’s
mate, one of those whom the President could
assign as he saw fit. Grasson is not mentioned
in Heitman, however, and contemporary rec-
ords do not specify his status. It should be
noted that volunteer units did, at least on
occasion, provide their own surgeons. Brown,
Medical Department, pp. 73, 271; James Abner
Tobey, The Medical Department of the Army
(Baltimore: Johns Hopkins University Press,
1927), p. 8; Ashburn, Medical Department,
p. 24; and Francis B. Heitman, Historical
Register and Dictionary of the United States
Army From Its Organization, September 29,
1789, to March 2, 1903, 2 vols. (Washington:
Government Printing Office, 1903).

10. Sargent, “Diary,” pp. 237, 254, quote
from p. 242; Cyrus Townsend Brady, American
Fights and Fighters: Stories of the First Five

251

Wars of the United States From the War of
the Revolution to the War of 1812 (New
York: McClure, Phillips & Co., 1900), pp-
166-67; Extract from the Diary of Maj
Ebenezer Denny, 26 Oct 1791, Smith, St. Clair,
2: 255.

11. St. Clair Journal, Wilson, St. Clair, p.
71; Frazer E. Wilson, ed., Journal of Capt.
Daniel Bradley: An Epic of the Ohio Frontier
(Greenville, Ohio: Frank H. Jobes & Son,
1935), p. 26; Testimony of Major Zeigler in
House Committee Investigation, Smith, St.
Clair, 2: 290n.

12. Quote from Michael McDonough to
Patrick McDonough, 10 Nov 1791, in Wash-
ington, Library of Congress, Manuscript Divi-
sion, Peter Force Collection, Arthur St. Clair
Papers, series 7E, box 60, folders 1782, Ag24-
1793, Jul6; Sargent, “Diary,” pp. 253, 264,
268; Knopf, “Biographical Data,” Forman,
Physicians; Randolph Greenfield Adams and
Howard H. Peckham, eds., Lexington to Fallen
Timbers 1775-1794 (Ann Arbor; University
of Michigan Press, 1942), p. 37; Wilson,
Bradley, p. 24.

13. Quote from Michael McDonough to
Patrick McDonough, 10 Nov 1791, St. Clair
Papers; Wilson, St. Clair, p. 82; Extract from
the Diary of Maj Ebenezer Denny, Smith, Sr.
Clair, 2: 261; Wilson, Bradley, p. 34.

14. Wilson, Bradley, p. 34.

15. Sargent, “Diary,” p. 265, quote from p.
254.

16. Anthony Wayne to Henry Knox, 3 Aug
1792, in Richard C. Knopf, ed., 4 Campaign
Into the Wilderness: The Wayne-Knox-Picker-
ing-McHenry Correspondence, 5 vols. (Colum-
bus, Ohio: Anthony Wayne Parkway Board,
1955), 1: 45; U.S. Congress, Senate, Executive
Proceedings, 1: 117; Harmar, Inquiry, pp. 9,
23; Louis Smith, American Democracy and
Military Power: A Study of Civil Control of
Military Power in the United States (Chicago:
Unversity of Chicago Press, 1951), p. 177;
White, Federalists, p. 148. (See also Table 7.)

17. Wayne, “Orderly Book,” p. 350, quote
from p. 361.

18. Quote from Anthony Wayne to Henry
Knox, 3 Aug 1792, Knopf, Campaign, 1: 45;
Wayne, “Orderly Book,” p. 350.

19. Wayne, “Orderly Book,” p. 390, quote
252

from p. 363; Henry Knox to Anthony Wayne,
27 Jul and 7 Sep 1792, Knopf, Campaign, 1:
38, 76-717.

20. Quote from Wayne, “Orderly Book,” p.
403; Richard C. Knopf, ed., “A Surgeon’s Mate
at Fort Defiance: The Journal of Joseph Gard-
ner Andrews for the Year 1795,” Ohio Histori-
cal Quarterly 66 (1957): 37; Thomas Taylor
Underwood, Journal March 26, 1792, to March
18, 1800. An Old Soldier in Wayne's Army
(Cincinnati, Ohio: Society of Colonial Wars in
the State of Ohio, 1945), p. 3n.

21. Underwood, Journal, p. 5; Anthony
Wayne to Henry Knox, 2 Jul 1793, and Knox
to Wayne, 27 Jul 1793, Knopf, Campaign, 2:
105-6, 114-15; U.S. Congress, Senate, Execu-
tive Proceedings, 1: 117, Knopf, “Andrews,”
pp. 61, 170, 170n; John Boyer, “Daily Journal
of Wayne's Campaign,” American Pioneer 1
(1842): 320.

22. Quotes from Boyer, “Journal,” p. 320;
Dwight L. Smith, ed., “From Greene Ville to
Fallen Timbers,” Indiana Historical Society
Publications 16 (1951-52): 307; Return of the
Killed, Wounded and Missing of the Federal
Army Commanded by Major General Wayne
. .., in Washington, National Archives, Rec-
ords of the Office of the Secretary of War,
Record Group 107, Copies of War Department
Correspondence and Reports, 1791-96, Micro-
film Publication T982, p. 454; Richard C.
Knopf, ed., “Two Journals of the Kentucky
Volunteers, 1793 and 1794,” Filson Club His-
torical Quarterly 27 (1953): 266. (See also
Table 7 on organization of the Legion.)

23. Quote from Smith, “Greene Ville,” p.
278; Richard Allison to Anthony Wayne, 23
Jun 1794, cited by Virginius Hall, “Richard
Allison—Surgeon to the Legion,” Forman,
Physicians.

24. Boyer, “Journal,” pp. 351, 352.

25. Quote from William Clark, “William
Clark’s Journal of General Wayne's Cam-
paign,” Mississippi Valley Historical Review
1 (1914-15): 431; Wayne to Knox, 17 Oct
1794, and Wayne to Timothy Pickering, 2
Sep 1795, Knopf, Campaign, 3: 73-74; 4: 88.

26. Anthony Wayne to Timothy Pickering,
18 Nov 1795, Knopf, Campaign, 4: 88-89,
107, quotes from p. 88, and from Wayne to
Timothy Pickering, 5 Oct 1795, p. 106; Wayne,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

“Orderly Book,” p. 619; Charles Whittlesey,
“General Wadsworth’s Division, War of 1812,”
Western Reserve and Northern Ohio Historical
Society Tracts 2 (1879): 119.

27. James McHenry to Anthony Wayne, 16
Jul 1796, and Wayne to McHenry, 28 Aug
and 28 Oct 1796, Knopf, Campaign, 5: 26,
43, 71, 72.

28. Francis F. Beirne, War of 1812 (New
York: E. P. Dutton & Co., 1949), pp. 60-61;
David A. Durfee, ed., William Henry Harrison
1773-1841. John Tyler 1790-1862. Chronol-
ogy—D o ¢ ume nt s—Bibliographical Aids
(Dobbs Ferry, N.Y.: Oceana Publications,
1970), p. 7.

29. William Henry Harrison to Secretary of
War, 10 Jul 1811, General Orders, 20 Sep
1811, Harrison to Secretary of War, 13 Oct
and 18 Nov 1811, Log of the Army to Tippe-
canoe, 18 Nov 1811, Report of the Sick,
Wounded and Invalids . . ., n.d., in William
Henry Harrison, Governors’ Messages and Let-
ters, Messages and Letters of William Henry
Harrison, ed. Logan Esarey, 4 vols. (Indiana-
polis: Indiana Historical Commission, 1922),
1: 532, 532n, 586, 602, 629, 634, 642-43;
Certificates signed by Josiah D. Foster and
Hosea Blood, 1811, in Richard C. Knopf, ed.,
Document Transcriptions of the War of 1812
in the Northwest, 8 vols. (Columbus, Ohio:
Anthony Wayne Parkway Board, 1957-62),
5: part 1, p. 47.

30. Josiah D. Foster to George Cheyne
Shattuck, Jan 1812, Shattuck Papers, 3, Massa-
chusetts Historical Society, quoted in Leonard
K. Eaton, “Military Surgery in the Battle of
Tippecanoe,” Bulletin of the History of Medi-
cine 25 (1951): 460.

31. Quote from Adam Walker, 4 Journal
of Two Campaigns of the Fourth Regiment of
U.S. Infantry . . . 1811-1812 (Keene, N.H.:
privately printed, 1816), p. 11; General Orders
20 Sep 1811, Harrison to Secretary of War, 25
Sep 1811, and Report of 17 Dec 1811, Har-
rison, Messages, 1: 586, 589, 641.

32. Field Report, Harrison’s Army, 12 Oct
1811, and Harrison to Secretary of War, 29
Oct 1811, Harrison, Messages, 1: 597-98,
605; Marvin A. Kreidberg and Merton G.
Henry, History of Military Mobilization in
the United States Army 1775-1945, Depart-
ment of the Army Pamphlet 20-212, June
Notes to Chapter 6

1955, p. 42; John K. Mahon, The War of
1812 (Gainesville: University of Florida Press,
1972), pp. 20, 21; Walker, Journal, p. 18.

33. Harrison to Secretary of War, 18 Nov
1811, Harrison, Messages, 1: 630, 631; Beirne,
War of 1812, p. 62; Walker Journal, p. 85;
Eaton, “Tippecanoe,” p. 461.

34. Harrison to Secretary of War, 18 Nov
1811, and Log of the Army to Tippecanoe, 13
Nov 1811, Harrison, Messages, 1:630, 633,
634, quote from Harrison to Secretary of War,
4 Dec 1811; Walker, Journal, pp. 36-37;
James Ripley Jacobs, The Beginning of the
U.S. Army 1783-1812 (Port Washington,
N.Y.: Kennikat Press, 1947, reissued 1970),
p. 362.

35. Henry Knox to Speaker of the House,
28 Nov 1794, RG 107, T982, pp. 505-15.

36. Francis Paul Prucha, A Guide to the
Military Posts of the United States, 1789-
1895 (Madison: State Historical Society of
Wisconsin, 1964), p. 81; Henry Dearborn to
Lyman Spaulding, 9 Apr 1802, in Washington,
National Archives, Records of the Office of the
Secretary of War, Record Group 107, Letters
Sent by the Secretary of War Relating to Mili-
tary Affairs, 1800-89, Microfilm Publication
M6, roll 1, p. 188; Testimony of Capt Christie,
Wilkinson, Memoirs, 2: 414.

37. Henry Dearborn to Thomas Cushing, 23
Feb 1803, and Dearborn to John Carmichael,
31 Aug 1803, RG 107, M6, roll 1, pp. 373-74;
roll 2, p. 54; quote from Dearborn to James
Wilkinson, 7 Mar 1803, roll 1, p. 380; Capt
John Bowyer and other officers to Secretary
of War, 13 May 1804, RG 107, M221, roll 1;
U.S. Congress, Senate, Executive Proceedings,
1: 414; Knopf, “Biographical Data,” Forman,
Physicians; Thomas H. S. Hamersly, Complete
Army and Navy Register of the United States
of America, From 1776 to 1887 (New York:
T. H. S. Hamersly, 1888), p. 51; Disposition
of Dr. J. F. Carmichael, Wilkinson, Memoirs,
2: app. 21.

38. Wilson, St. Clair, p. 71; American State
Papers: Military Affairs, 1: 67; Wilson, Brad-
ley, p. 76n; Frazer Ells Wilson, Fort Jefferson:
The Frontier Post of the Upper Miami Valley:
A Fascinating Tale of Border Life Gleaned
From Authentic Sources and Retold by Frazer
Ells Wilson (Lancaster, Pa., 1950), p. 7;
John Heckwelder, “Narrative of His Journey

253

to the Wabash in 1792,” Pennsylvania Maga-
zine of History and Biography 12 (1888):
12, 42.

39. Prucha, Guide, p. 71; Knopf, “An-
drews,” pp. 57, 60, 69, 75; Henry Dearborn to
Jonathan Sparhawk, 18 Oct 1803, RG 107,
M6, roll 2, p. 83; Francis LeBaron to Secre-
tary of War, 30 Sep 1810, RG 107, M221,
roll 38.

40. All material on Andrews, unless other-
wise indicated, is based on Knopf, “Andrews,”
pp. 60-262, and the quotes in the following
paragraphs are from pp. 176, 241, 244, 248,
260, 261, and 262.

41. Unless otherwise indicated, the section
on Wilkinson is based on Jacobs, Wilkinson.
General Wilkinson later wrote a lengthy de-
fense of his conduct at this time, but his
memoirs must be considered in the light of the
author’s reputation for “deviousness” (Weig-
ley, Army, p. 107).

42. James Wilkinson to William Eustis, 19
Aug 1809, Report of William Upshaw, Sur-
geon 5th Infantry, 20 Jul 1809, and Report
of Alfred Thruston, Surgeon 7th Infantry, 29
Jul 1809, American State Papers: Military
Affairs, 1: 270, 292-93; Hamersly, Register,
p. 55; Kreidberg and Henry, Mobilization,
p. 41; “Sickness in the Army at New Orleans,
in 1809,” Medical Repository 14 (1811): 85-
87; Deposition of Dr. Theodore Elmer, Orders
to Brig Gen James Wilkinson from H. Dear-
born, 2 Dec 1808, and William Eustis to Dr.
Oliver Spencer, Surgeon, Aug 1809, Wilkin-
son, Memoirs, 2: 342, 450-510, app. 109. See
also other material, 2: 414, 431, 506, and app.
109.

43. Wilkinson, Memoirs, 2: 408-9, 410,
414, 425, and Testimony of Col Electus Back-
us, app. 108; Hamersly, Register, p. 55.

44. Wilkinson, Memoirs 2: 346-47, 506,
Testimony of Col Electus Backus, app. 108,
Deposition of Lieutenant-Colonel Beall, app.
111, and James Wilkinson to Secretary of
War, 19 Apr 1809, 2: 349, quote from p.
350; William Eustis to James Wilkinson, 30
Apr 1809, American State Papers: Military
Affairs, 2: 269.

45. Wilkinson, Memoirs, 2: 371, 375-76;
William Eustis to James Wilkinson, 30 Apr
1809, American State Papers: Military Affairs,
1: 269; “Sickness in the Army,” p. 86.
254

46. Jacobs, The Beginning, pp. 346, 347;
James Wilkinson to Secretary of War, 20 May
1809, American State Papers: Military Affairs,
1: 269; Wilkinson, Memoirs, 2: 367-68, 390;
“Sickness in the Army,” p. 85; Jabez W. Heus-
tis, “Observations on the Disease Which Pre-
vailed in the Army at Camp Terre-aux-Boeufs,
in June, July, and August of the Year 1809,”
Medical Repository, 2d ser. 3 (1817): 38.

47. Wilkinson, Memoirs, 2: 372.

48. “Sickness in the Army,” p. 87; James
Wilkinson to William Eustis, 19 Aug 1809,
and William Upshaw Report, 20 Jul 1809,
American State Papers: Military Affairs, 1:
220, 292-93; Heustis, “Observations,” p. 38;
Wilkinson, Memoirs, 2: app. 108.

49. Jacobs, The Beginning, pp. 349, 352-
53; Wilkinson, Memoirs, 2: 430, 483-84, 485,
Eustis to Spencer, Aug 1809, pp. 450-51;
Eustis to Dr. John M. Daniel, 1809, p. 479.

50. Wilkinson to Eustis, 18 Jun 1809, and
Eustis to Wilkinson, 22 Jun 1809, American
State Papers: Military Affairs, 1: 269; Wilkin-
son, Memoirs, 2: 386.

51. Wilkinson, Memoirs, 2: 406, 407, 417;
Jacobs, The Beginning, p. 351; Report of Al-
fred Thruston, 29 Jul 1809, American State
Papers: Military Affairs, 1: 293.

52. Wilkinson, Memoirs, 2: 417, Testimony
of Col Electus Backus, app. 108, and Deposi-
tion of Captain Dale, app. 111.

53. Wilkinson, Memoirs, 2: 480 and app.
108.

54. William Eustis to James Wilkinson, 10
Sep 1809, Wilkinson, Memoirs, 2: app. 110,
data and quote from Deposition of Doctor
Dow, app. 109.

55. Quote from William Upshaw Report, 20
Jul 1809, American State Papers: Military
Affairs, 1: 292-93; Heustis, “Observations,”
pp. 34, 36; “Sickness of the Army,” pp. 86-
87; Deposition of Lieutenant-Colonel Beall,
Wilkinson, Memoirs, 2: app. 111.

56. Medical Department, United States
Army, Communicable Diseases, Preventive
Medicine in World War II, vol. 6 (Washing-
ton: Government Printing Office, 1963), chart
1, p. 14, and table 9, p. 112; Wilkinson,
Memoirs, 2: 427.

57. Wilkinson, Memoirs, 2: 347; Deposi-
tions of Captain Dale and Lieutenant-Colonel
Beall, app. 111; data and quote from John

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Smith, for Secretary of War, to Abraham D.
Abrahams, 20 Aug. 1808, 2: 435.

58. Heustis, ““ Observations,” pp.
quote from pp. 33-34.

59. Heustis, “Observations,” pp. 35, 36.

60. Heustis, “Observations,” pp. 35, 36, 39,
quotes from pp. 37, 38, 41.

61. Heustis, “Observations,” pp. 36, 40, 41,
quote from p. 40. After studying contemporary
accounts of the condition of Wilkinson’s men
at this time, Col Robert J. T. Joy, MC, in
1976 Director of the Walter Reed Army Insti-
tute of Research in Washington, D.C., com-
mented that “these troops were the victims of
a combination of events—any one or two of
which would have been enough to cripple a
force; in combination, the force was de-
stroyed.” Colonel Joy believed that their con-
dition resulted from “A combination of vita-
min deficiency, starvation, and malaria as the
common substrate upon which diarrhea, dysen-
tery, hepatitis, typhoid, and pneumonia were
laid, all being helped along by poor housing,
poor clothing, and demands for hard physical
labor, with a shortage of moderately effective
medicine and the overuse of a useless, or dan-
gerous therapy. Any one man didn’t have to
have everything—just a few would kill him.”
The only effective medicines available to these
men were opium for diarrhea and bark for
malaria. The oral lesions, Colonel Joy noted,
resulted from the overuse of mercury and pos-
sibly from scurvy as well. (Letter to the author,
11 Jun 1976.)

62. Risch, Quartermaster Support, pp. 76-
84; General Orders, Harrison, Messages, 1:
586; Clark, “Journal,” p. 431; White, Federal-
ists, p. 148; Boyer, “Journal,” p. 351; Wayne
to Henry Knox, 2 Jul 1793, Timothy Picker-
ing, 2 Sep and 5 Oct 1795, and James Mc-
Henry, 28 Oct 1796, Knopf, Campaign, 2:
105-6; 4: 88, 106, 107; 5: 71; Dittrick, “Medi-
cal Agents,” Forman, Physicians; Francis Le-
Baron to Secretary of War, 20 Jun 1802, 30
Sep 1810, and Will Stewart to Secretary of
War, 30 Mar 1812, RG 107, M221, rolls 38
and 40; Dearborn to Maj Constant Freeman,
27 Jun 1801, Wilkinson, 17 Jul 1801, Thomas
Cushing, 20 Mar 1802, Israel Whelen, 27
Mar 1802, and Secretary of War to Smith
Cutler, 14 Jan 1809, RG 107, M6, roll 1, pp.
91, 95, 165-66, 171-75; roll 4, p. 12.

33, 37,
Notes to Chapter 7

63. William Eustis to Benjamin Rush, 2 Jan
1810, 31 May 1810, Eustis to Dr. James
Mease, 31 May 1810, RG 107, M6, roll 4, pp.
254, 363, quote from Secretary of War to
Smith Cutler, 14 Jan 1809, p. 12; Dittrick,
“Medical Agents,” Forman, Physicians; James
Mease to Secretary of War, 28 Jan and 28
May 1810, RG 107, M221, roll 38.

64. Quote from Secretary of War to Tench
Coxe, 12 Feb 1812, RG 107, M6, roll 5, p.
273; Francis LeBaron to Adjutant General, 30
Jun and 4 Dec 1812, in Washington, National
Archives, Records of the Adjutant General's
Office, 1780s-1917, Record Group 94, Letters
Received by the Adjutant General 1805-21,
Microfilm Publication M566, roll 12; Francis
LeBaron to Secretary of War, 26 Feb 1812,
RG 107, M221, roll 46.

65. Francis LeBaron to Secretary of War, 13
Feb and Apr 1812, RG 107, M221, roll 46.

66. Secretary of War to Francis LeBaron,
14 Jul and 24 Aug 1812, quote from Secretary
of War to Francis LeBaron, 20 Aug 1812, RG
107, M6, roll 6, pp. 25, 95, 96, 100; LeBaron
to Secretary of War, 26 Feb 1812, RG 107,
M221, roll 46.

67. William Atherton, Narrative of the Suf-
fering & Defeat of the Northwestern Army
Under General Winchester . . . (Frankfort,
Ky., 1842), p. 39.

CHAPTER 7

1. Unless otherwise indicated, the material
in this chapter is based on Beirne, War of
1812; Brown, Medical Department, pp. 81-
100; James Ripley Jacobs and Glenn Tucker,
The War of 1812: A Compact History (New
York: Hawthorn Books, 1969); Weigley,
Army, pp. 97-133, 566; and Charles Maurice
Wiltse, The New Nation, 1800-1845 (London:
Macmillan, 1965).

2. Secretary of War to Henry Dearborn, 26
Aug 1812, RG 107, M6, roll 6, p. 100, quote
from Secretary of War to Francis LeBaron, 24
Aug 1812, p. 95.

3. Secretary of War to Francis LeBaron, 29
Aug 1812, RG 107, M6, roll 6, p. 104.

4. LeBaron to Secretary of War, 17 Oct
1812, RG 107, M221, roll 46; Secretary of
War to LeBaron, 25 Aug 1812, RG 107, M6,
roll 6, p. 96.

255

5. Secretary of War to Francis LeBaron, 4
and 9 Oct 1812, RG 107, M6, roll 6, pp. 181,
188; Francis LeBaron to Secretary of War, 17
Oct 1812, RG 107, M221, roll 46.

6. Francis LeBaron to Secretary of War, 13
Nov 1812, RG 107, M221, roll 46; Secretary
of War to Francis LeBaron, 16 Oct 1812 and
12 May 1813, RG 107, M6, roll 6, pp. 195.
413-14.

7. Francis LeBaron to Adjutant and In-
spector, Washington City, 8 Dec 1812, RG 94,
M566, roll 12, quotes from Francis LeBaron to
Adjutant General, 5 Oct 1812.

8. Unless otherwise indicated, Callan, Mili-
tary Laws has formed the basis of discussions
of the laws governing the activities of the
Medical Department.

9. American State Papers: Military Affairs,
1: 428, 432-33, 435, quote from p. 434;
Thomas H. Palmer, ed., Historical Register of
the United States, 4 vols. (Philadelphia, 1814-
16), 3: 7; Marguerite McKee, “Service of
Supply in the War of 1812,” Quartermaster
Review 6 (1927): 51.

10. Niles’ Weekly Register (Baltimore) 6:
36; American State Papers: Military Affairs, 1;
384-85; Wolfe, “Genesis,” pp. 842-43.

11. James Mann, Medical Sketches of the
Campaigns of 1812, 13, 14 . . . (Dedham,
Mass.: H. Mann and Co., 1816), p. 75; Sec-
retary of War to Francis LeBaron, 6 Aug 1813
and 6 Jul 1814, RG 107, M6, roll 7, pp. 31,
252.

12. Regulations for the Medical Department,
Dec 1814, Brown, Medical Department, pp.
94-98; Palmer, Historical Register, 3: 709;
Tilton to Assistant Inspector General, 4 Jun
1814, RG 94, M566, roll 59.

13. Quote from T. R. Adams, “The Medical
and Political Activities of Dr. James Tilton,”
Annual Report of the John Carter Brown
Library (Providence, R.I.: The John Carter
Brown Library, Brown University and the
Colonial Society of Massachusetts) 7 (1972):
30; Tilton, Observations.

14. Quote from James Tilton to Secretary of
War, 23 Aug 1814, RG 107, M221, roll 66;
Benjamin Waterhouse to Secretary of War, 12
Jul 1815, RG 107, M221, roll 67.

15. Quote from James Tilton to Secretary of
War, 19 Sep 1814, in Washington, National
256

Archives, Records of the Office of the Secretary
of War, Record Group 107, Letters Received
by the Secretary of War, Unregistered Series,
1789-1861, Microfilm Publication M222, roll
10. Brown states that the leg was amputated in
1814 but Phalen maintains that the operation
was performed 7 December 1815 (Chiefs, p.
25). Neither his letters nor those of his col-
leagues in late 1814 and 1815 refer even
obliquely to his having undergone major sur-
gery (see letters of Tilton for this period in RG
94, M566, rolls 59 and 82; RG 107, M221,
rolls 66 and 67; and RG 107, M222, roll 10;
as well as Benjamin Waterhouse to Secretary of
War, 12 Jul 1815, RG 107, M221, roll 67).
Thus it seems safe to assume that Brown was
mistaken as to the date of the amputation (see
p. 98 in Medical Department). Tilton’s fre-
quent presence in Wilmington is established by
the many letters he sent from that city (see
James Tilton to Adjutant General, 5 Feb, 4, 7,
9, 30 Jun, 15 Aug, 19 Sep, 4, 15 Oct, 3,
8 Nov, and 5 Dec 1814, RG 94, M566, roll
59).

16. American State Papers: Military Affairs,
1: 591; Francis LeBaron to Secretary of War,
17 Jun 1813, and to Adjutant General, 20 Dec
1814, RG 94, M566, roll 12; Francis LeBaron
to Secretary of War, 2 June 1814, RG 107,
M221, roll 63; McKee, “Service of Supply,”
p- 51.

17. Office of Adjutant General to James
Tilton, 29 May 1814, in Washington, National
Archives, Records of the Adjutant General's
Office, 17805-1917, Record Group 94, Letters
Sent by the Office of the Adjutant General,
Main Series, 1800-1890, Microfilm Publication
M565, roll 4, vol. 3, p. 547.

18. Quote from James Tilton to Assistant
Inspector General, 4 Jun 1814, RG 94, M566,
roll 59.

19. James Tilton to Secretary of War, 10
Feb 1815, RG 107, M221, roll 66.

20. Quote from James Tilton to Secretary of
War, 20 Aug 1814, RG 107, M221, roll 66;
Statement of Dr. Catlett, 1814, American State
Papers: Military Affairs, 1: 584; William M.
Marine, The British Invasion of Maryland,
1812-1815 (Baltimore: Society of the War of
1812 in Maryland, 1913), p. 174; Office of
Adjutant General to Dr. John R. Martin, 26

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Jun 1813, 21 and 23 Feb, 15 Mar, and 26 Jun
1814, RG 94, M565, roll 4, 3: 216, 373, 379,
412, 543.

21. James Ewell, The Medical Companion
«+. , 3d ed. (Philadelphia: privately printed,
1817), pp. 690-91.

22. Tilton to Secretary of War, 27 Oct 1814,
RG 107, M221, roll 66, quotes from roll 59:
Mann, Sketches, pp. 255-56.

23. James Mann to James Tilton, 14 Feb
1814, Brown, Medical Department, p- 93.

24. Benjamin Waterhouse to Tilton, 13 Aug
1814, RG 107, M221, roll 82, quotes from
Waterhouse to Secretary of War, 13 Aug 1814,
roll 67; A. Hays to James Tilton, 2 Oct 1814
and 2 Jan 1815, RG 94, M566, rolls 59, 82;
Tilton to Secretary of War, 19 Sep 1814, RG
107, M222, roll 10. A black cockade, worn on
the hat, was a part of the Army’s uniform
(American State Papers: Military Afiairs, 1:
434).

25. Tilton to Secretary of War, 20 Aug 1814
and 10 Feb 1815, RG 107, M221, roll 66;
Charles Smart, The Connection of the Army
Medical Department With the Development of
Meteorology in the United States, U.S. De-
partment of Agriculture, Weather Bureau, Re-
port of the International Meteorological Con-
gress held at Chicago, Ill, 21-24 Aug 1893,
Bulletin No. 11, part 2 (1895): 208; Palmer,
Historical Register, 3: 8.

26. Tilton to Secretary of War, 20 Aug
1814, RG 107, M221, roll 66; Palmer, His-
torical Register, 3: 7-8.

27. Tilton to Secretary of War, 10 Feb 1815,
RG 107, M221, roll 66.

28. McKee, “Service of Supply,” p. 51;
Kreidberg and Henry, Mobilization, pp. 58-
59; Jabez W. Heustis, Physical Observations
and Medical Tracts and Researches on the
Topography and Diseases of Louisiana (New
York: T. and J. Swords, 1817), pp. 105n-
106n; Brereton Greenhous, “A Note on West-
ern Logistics in the War of 1812,” Military
Affairs 34 (1970): 43.

29. Office of Adjutant General to Members
of the General Staff, 29 Oct 1814, RG 94,
M565, roll 5, vol. 3Y; Secretary of War to
LeBaron, 21 Jun 1813, RG 107, M6, roll 6,
pp. 468-69; LeBaron to Secretary of War, 28
Jul 1813, RG 107, M221, roll 54.
Notes to Chapter 8

30. Secretary of War to LeBaron, 24 Mar
1813, RG 107, M6, roll 6, p. 336.

31. Quotes and data from Secretary of War
to LeBaron, 16 Oct 1813, RG 107, M6, roll
7, pp. 93, 94; LeBaron to Secretary of War,
29 Jun 1814, RG 94, M566, roll 12; LeBaron
to Secretary of War, 18 Sep 1814, RG 107,
M221, roll 63.

32. LeBaron to Secretary of War, 30 Mar
1813, RG 107, M221, roll 54, quote from Dr.
Shaw to Secretary of War, 21 Apr 1813, roll
57; Secretary of War to LeBaron, 24 May
1813, RG 107, M6, roll 6, p. 336.

33. Joseph Lovell to Secretary of War, 18
May 1813, LeBaron to Secretary of War, 30
Mar and 9 Jun 1813, RG 107, M221, roll 54;
Secretary of War to Francis LeBaron, 12 May
and 25 Jun 1813, RG 107, M6, roll 6, pp.
413-14, 474.

34. LeBaron to Secretary of War, Dec and
30 Mar 1813, 21 Mar 1814, RG 107, M221,
roll 54, quote from Dec 1813; James Mann to
LeBaron, n.d., Mann, Sketches, p. 259; Sec-
retary of War to LeBaron, 12 May 1813 and
11 Apr 1814, RG 107, M6, roll 6, pp. 413-14;
roll 7, p. 160.

35. James Cutbush to Adjutant General, 31
Dec 1814, RG 94, M566, roll 4.

CHAPTER 8

1. Except where otherwise noted, all military
and political material is based on Beirne, War
of 1812; Harry L. Coles, The War of 1812
(Chicago: University of Chicago Press, 1965);
Jacobs and Tucker, The War of 1812; Kreid-
berg and Henry, Mobilization; and Mahon,
The War of 1812.

2. James Mann to Secretary of War, 17 Aug
1812, RG 107, M221, roll 47; Mann, Sketches,
p. Vi.

3. Mann, Sketches, pp. vi, 12, 45-46; James
Mann to Secretary of War, 17 Aug and 5 Oct
1812, RG 107, M221, roll 47; William Beau-
mont, William Beaumont's Formative Years:
Two Early Notebooks, 1811-1821, ed. Gene-
vieve Miller (New York: Henry Schuman,
1946), p. 10.

4. Mann, Sketches, p. vi; James Mann to
Secretary of War, 17 Aug and 5 Oct 1812, RG
107, M221, roll 47.

257

5. James Mann to Secretary of War, 5 Oct
1812, RG 107, M221, roll 47.

6. Mann, Sketches, pp. 13, 14, 15, 19, 20;
James Mann to Secretary of War, 5 Oct 1812,
RG 107, M221, roll 47.

7. Mann, Sketches, pp. 15-16.

8. Mann, Sketches, pp. 13-14, 20, 34,
quotes from p. 13.

9. Mann, Sketches, pp. 15, 19, quote from
p. 14.

10. Beaumont, Notebooks, pp. xii, 11,
quotes from p. 11; Secretary of War to Mr.
Leib, 27 Nov 1812, in Washington, Library of
Congress, Manuscript Division, William Eustis
Papers, I1I-33-N.H.; Ashburn, Medical De-
partment, pp. 50-53.

11. Mann, Sketches, pp. 4, 14, quotes from
pp. 14, 35-36.

12. Mann, Sketches, pp. 25, 44, quote from
p. 44.

13. Mann, Sketches, pp. 43, 45; Brown,
Medical Department, p. 83; Phalen, Chiefs,
p. 27.

14. Mann, Sketches, pp. 45, 47, quote from
p. 45.

15. Louis L. Babcock, The War of 1812 on
the Niagara Frontier (Buffalo, N.Y.: Buffalo
Historical Society, 1927), pp. 64-65, letter of
11 Nov 1812, published in the New York Eve-
ning Post of 25 Nov 1812, quote from letter
of 8 Nov 1812, published in the New York
Evening Post of 25 Nov 1812; John Brannan,
Official Letters of the Military and Naval Of-
ficers of the United States During the War
With Great Britain (Washington: Way &
Gideon, 1823), p. 100.

16. Report of the State of the 14th Regi-
ment of Infantry, Babcock, Niagara, pp. 62—
63; Amos Stoddard, Maj Ist Regt. Artillery, to
Secretary of War, 16 Sep 1812, Knopf, Docu-
ments, 6, part 3: 160; Brannan, Letters, p. 95.

17. Elijah D. Efner, “The Adventures and
Enterprises of Elijah D. Efner,” Publications
of the Buffalo Historical Society 4 (1896):
44; John C. Parish, ed., The Robert Lucas
Journal of the War of 1812 (Iowa City, Iowa:
The State Historical Society of Iowa, 1906),
p. 18; Extract of letter of Dr. James Reynolds
from Detroit, 7 Jul 1812, Knopf, Documents,
5, part 1: 112; William Stanley Hatch, 4
Chapter of the History of the War of 1812 in
258

the Northwest . . . (Cincinnati: Miami Print-
ing and Publishing Co., 1872), p. 25.

18. William Hull, Memoirs of the Cam-
paign of the Northwestern Army of the
United States, 1812 (Boston: True & Greene,
1824), pp. 3, 10; Parish, Lucas Journal, p. 19;
Walker, Journal, p. 48; Samuel R. Brown, An
Authentic History of the Second War for In-
dependence . . . , 2 vols. (Auburn, N.Y.: J. G.
Hathaway, 1815), 1: 37n; Efner, “Adven-
tures,” p. 44.

19. Parish, Lucas Journal, pp. 19, 63-64;
Walker, Journal, p. 48; Brown, Authentic His-
tory, 1: 37n; John Miller to Gen Thomas
Worthington, 24 Nov 1812, Knopf, Docu-
ments, 3: 123; William Kennedy Beall, “Jour-
nal of William K. Beall, July-August 1812,”
reprinted from American Historical Review
17 (1912): 785-86; Clarence Stewart Peter-
son, Known Military Dead During the War of
1812 (Baltimore, April 1955), p. 55; G. M.
Fairchild, Jr., ed., Journal of an American
Prisoner at Fort Malden and Quebec in the
War of 1812 (Quebec: privately printed,
1909), p. 304.

20. William Hull to Secretary of War, 26
Aug 1812, Brannan, Letters; Fanny J. Ander-
son, “Medical Practices During the War of
1812,” Bulletin of the History of Medicine 16
(1944): 268; Brown, Authentic History, 1:
68; U.S. Congress, Senate, Executive Proceed-
ings, 1: 473; Orders, Brig Gen William Hull,
7 Aug 1812, in Milo Milton Quaife, ed., War
on the Detroit, The Chronicles of Thomas
Verchéres de Boucherville and the Capitula-
tion by an Ohio Volunteer (Chicago: Lake-
side Press, 1940), pp. 195n-196n, 275-76;
Abraham W. Beth to Gen Thomas Worthing-
ton, 8 Jan 1812, H. Johnson to Secretary of
War, 16 and 18 Aug 1812, and A. Edwards
to Secretary of War, 17 Sep 1812, Knopf,
Documents, 3: 37; 6, part 3: 36, 39, 162;
Fairchild, Journal, p. 7.

21. Coles, 1812, p. 55.

22. Letter from Captain Heald, 23 Oct
1812, and T. Forsythe to Governor Howard,
7 Sep 1812, Knopf, Documents, 5: part 1:
269; 6, 118; Peterson, Dead, p. 68; William
Jay, “Table of the Killed and Wounded in
the War of 1812. Compiled During the War,”
Collections of the New York Historical So-
ciety, 2d ser. 2 (1849): 449; John Kinzie,

THE ARMY MEDICAL DEPARTMENT,

1775-18138

“Narrative of the Ft. Dearborn Massacre,”
Illinois State Historical Society 46 (1953):
349.

23. Brown, Authentic History, 2: 85, 87-88;
Atherton, Narrative, pp. 18-19; Samuel Hop-
kins to Governor Shelby, 27 Nov 1812, and
Lt Col John B. Campbell to Gen W. H. Har-
rison, 25 Dec 1812, Brannan, Letters, pp- 97,
115-16.

24. Elias Darnell, “A Journal Containing
an Accurate and Interesting Account of the
Hardships, Sufferings, Battles, Defeat, and
Captivity of Those Heroic Kentucky Volun-
teers and Regulars, Commanded by General
Winchester, in the Years 1812-13 . . . ”
Magazine of History, Extra No. 31 (New
York: W. Abbatt, 1914 reprint of 1854 ed.),
p. 203, quote from p. 210; Winchester’s Gen-
eral Orders, Camp Defiance, 1 and 9 Oct
1812, James Winchester, “Papers and Orderly
Book of Brigadier General J. Winchester,”
Michigan Pioneer and Historical Society Col-
lections 31 (1901): 259, 264-65; Harrison's
Orders, 3 Oct 1812, in Washington, Library of
Congress, Manuscript Division, microfilm of
William Henry Harrison Papers, roll 1, series
I; Charles E. Slocum, “Some Errors Cor-
rected: Fort Winchester, at Defiance, Ohio,”
Ohio Archeological and Historical Quarterly
10 (1901-2): 483; Atherton, Narrative, pp.
18-19.

25. Atherton, Narrative, p. 19.

26. Hull, Memoirs, p. 3; William Henry
Harrison to James Winchester, 4 Oct 1812,
and to Secretary of War, 20 Jan 1813, Har-
rison, Messages, 2: 162, 316.

27. Brown, Authentic History, 1: 89-90;
Thomas P. Dudley, “Battle and Massacre at
Frenchtown, Michigan, January 1813, by Rev.
Thomas P. Dudley, One of the Survivors,”
Western Reserve and Northern Ohio Histori-
cal Society Publications No. 1 (1870): 1-2,
3; James Winchester to William Henry Har-
rison, 17 and 19 Jan 1813, William Lewis to
James Winchester, 20 Jan 1813, and McClana-
han to William Henry Harrison, 26 Jan 1813,
Harrison, Messages, 2: 314, 315, 321, 339;
Atherton, Narrative, p. 39; Statement of Capt.
R. Matson of 13 Feb 1813, and Statement of
James Garrard, Jr., Brigade Inspector, 11 Mar
1813, Knopf, Documents, 5: part 2: 27, 40;
Garrett Glenn Clift, Remember the Raisin:
Notes to Chapter 8

Kentucky and Kentuckians in the Battles and
Massacre at Frenchtown, Michigan Territory,
in the War of 1812 (Frankfort: Kentucky His-
torical Soc., 1961), pp. 127, 128, 129, 131-
32, 134-35.

28. Atherton, Narrative, pp. 53-54, 61;
Darnell, “Journal,” pp. 220, 222, 223; Brown,
Authentic History, 1: 92.

29. William Henry Harrison to Governor
Meigs, 24 Jan 1813; Harrison, Messages, 2:
329-30.

30. Register of the Army for 1813, Amer-
ican State Papers: Military Affairs, 1: 391.

31. William Henry Harrison to Secretary of
War, 9 Jul 1813, Harrison, Messages, 2: 485,
quote from p. 486.

32. Jay, “Table,” p. 452; Eleazer D. Wood,
“Journal of the Northwestern Campaign of
1812-13 Under Major-General William Har-
rison,” in G. W. Cullum, ed., Campaigns of
the War of 1812-15 (New York: Miller,
1879), p. 402, quotes from pp. 402, 403.

33. Cullum, Campaigns, p. 403, quote from
p. 401; William Henry Harrison to Secretary
of War, 5 May 1813, Brannan, Letters, p. 158.

34. William Henry Harrison to Secretary of
War, 5 May 1813, Brannan, Letters, p. 158.

35. Cullum, Campaigns, p. 402.

36. Robert Yost, “His Book,” Ohio Archae-
ological and Historical Quarterly 23 (1914):
154-55; Duncan McArthur to Secretary of
War, 6 Oct 1813, Brannan, Letters, p. 230.

37. Yost, “Book,” pp. 156-57, quote from
p. 157; Anderson, “Medical Practices,” p. 269;
William Henry Harrison to Secretary of War,
9 Oct 1813, Brannan, Letters, p. 238.

38. James Wilkinson to Secretary of War,
16 Nov 1813, American State Papers: Mili-
tary Affairs, 1: 476; Wilkins Report, 3 Nov
1813, and Major Birdsall Statement, 6 Nov
1813, in John Armstrong, Notices of the War
of 1812, 2 vols. (New York: Wiley & Putnam,
1840), 2: 9, 211-12.

39. Register, Rules and Regulations of the
Army for 1813, American State Papers: Mili-
tary Affairs, 1: 384-85; James Tilton to Sec-
retary of War, 20 Aug 1814, RG 107, M221,
roll 66.

40. Mann, Sketches, pp. 64-65, 248, 249,
quote from p. 248.

41. Jesse S. Myer, Life of William Beau-
mont (St. Louis: C. V. Mosby Co., 1939), pp.

259

44-45, 53-54; Mann, Sketches, pp. 94, 95,
126, quote from p. 250; Beaumont, Notebooks,
pp. 16, 47, 48; W. E. Horner, quoted in
Brown, Medical Department, p. 92; Green-
hous, “Logistics,” p. 43.

42. Winfield Scott, Memoirs of Lieut.-Gen-
eral Scott, LL.D., 2 vols. (New York: Sheldon
& Co., 1864), 1: 145.

43. Mann, Sketches, pp. 241, 242, 24647,
Brown, Medical Department, p. 89.

44. Register of the Army for 1813, Amer-
ican State Papers: Military Affairs, 1: 391;
Mann, Sketches, p. 45.

45. Quote from Beaumont, Notebooks, p.
44; Mann, Sketches, p. 117; Secretary of War
to Major General Hampton, 25 Sep 1813, in
Ernest A. Cruikshank, Documentary History
of the Campaign Upon the Niagara Frontier,
4 vols. (Welland, Ont.: Arno Press & New
York Times, 1971 reprint of 1896-1908 edi-
tion), 2: 107.

46. Beaumont, Notebooks, pp. 15, 43, 44;
Mann, Sketches, p. 58, quote from p. 57.

47. Beaumont, Notebooks, p. 15.

48. Mann, Sketches, pp. 57, 58: Lewis Pot-
ter Bush, The Delaware State Medical Society
and Its Founders in the Eighteenth Century
(New York, 1886), p. 9.

49. Secretary of War to Dr. Ross, 22 Jun
1813, RG 107, M6, roll 6, p. 472; Wilkinson,
Memoirs, 3: app. 9 #2 and 26, and Remarks
on the Weekly Sick Report Made by Order of
Brigadier General Brown, Commanding at
Sackett’s Harbor, Saturday, September 18,
1813, app. 9 #2 (there are two appendixes
9 in this volume); American State Papers:
Military Affairs, 1: 387; Jay, “Table,” p. 452.

50. Mann, Sketches, pp. 62-63, 89; Arm-
strong, War of 1812, 2: 22.

51. Mann, Sketches, p. 70, Joseph Lovell
quoted in Mann, p. 67, quotes from pp. 65-
66, 71; Colonel Scott to Wilkinson, 11 Oct
1813, American State Papers: Military Af-
fairs, 1: 483.

52. Colonel Scott to James Wilkinson, 11
Oct 1813, American State Papers: Military
Affairs, 1: 483; Francis LeBaron to Secretary
of War, 12 Sep 1813, RG 107, M221, roll 54;
Mann, Sketches, pp. 62-63, 66.

53. Mann, Sketches, pp. 62-63, 64-65, 252;
Beaumont, Notebooks, p. 51; Francis LeBaron
260

to Secretary of War, 6 May 1813, RG 107,
M221, roll 54.

54. Mann, Sketches, pp. 64-65, 93-94, 241,
quote from p. 64; Scott, Memoirs, 1: 136.

55. Mann, Sketches, p. 63, quote from p.
89.

56. Colonel Scott to James Wilkinson, 11
Oct 1813, American State Papers: Military
Affairs, 1: 483; Mann, Sketches, pp. 94, 95,
quote from p. 94.

57. Secretary of War to Major General
Hampton, 25 Sep 1813, Cruikshank, Docu-
ments, 2: 107; Mann, Sketches, pp. 95, 96-97,
117, quote from pp. 96-97. Joseph Lovells
report of the summer of 1814 states that a
hospital was established at Williamsville on 1
August 1814, implying that for some time
before that date, there was no hospital in
operation there (Lovell report, Mann,
Sketches, p. 162).

58. Beaumont, Notebooks, pp. 16, 46, 47,
quotes from pp. 16, 46; Stephen H. Moore to
his brother, 5 May 1813, Brannan, Letters,
p. 131,

59. Beaumont, Notebooks, pp. 16, 47, 48,
51.

60. Quote from Colonel Purdy’s Report,
fall 1813, Brannan, Letters, 277-78; Mann,
Sketches, p. 119; Dr. Ross to Inspector Gen-
eral, 8 Dec 1813, Wilkinson, Memoirs, 3:
app. 9 #1.

61. Dr. Ross to Inspector General, 8 Dec
1813, Wilkinson, Memoirs, 3: app. 9 #1.

62. Joseph Lovell quoted in Mann, Sketches,
p. 119.

CHAPTER 9

1. Unless otherwise indicated, material con-
cerning military activities in this chapter is
based upon Beirne, War of 1812; Coles,
1812; Mahon, The War of 1812; Matloff,
Military History; and Spaulding, Army.

2. Unless otherwise indicated, material con-
cerning the Medical Department in this chap-
ter is based on Brown, Medical Department.
The preceding paragraph is also based on
Henry Huntt, “An Abstract Account of the
Diseases Which Prevailed Among the Soldiers,
Received into the General Hospital, at Bur-
lington, Vermont, During the Summer and
Autumn of 1814,” Medical Recorder 1

THE ARMY MEDICAL DEPARTMENT,

1775-18138

(1818): 179; Register of the Army for 1813,
American State Papers: Military Affairs, 1:
391; Mann, Sketches, pp. 127, 144, 246-47,
256-57.

3. Mann, Sketches, p. 261, Mann to Gen-
eral Smith, Apr 1814, and to Colonel Smith,
21 Apr 1814, quote from Mann to Brigadier
General Smith, 28 Apr 1818, pp. 261, 265-
66, 267; George Izard to Secretary of War, 19
Jul 1814, in George Izard, Official Correspon-
dence With the Department of War Relative
to the Military Operations of the American
Army Under the Command of Major General
Izard on the Northern Frontier of the United
States in the Years 1814 and 1815 (Philadel-
phia: Thomas Dobson, 1816), pp. 54-55.

4. Data and quote from Huntt, “Burling-
ton,” p. 177; Purcell report, Mann, Sketches,
p. 153. Comments by Mann, in an essay writ-
ten several years before the war, suggested
that in the early nineteenth century physi-
cians believed that the difference between
diarrhea and dysentery lay in the fact that the
latter was characterized by cramps and tenes-
mus, even though the “evacuations are small,”
while the former involved copious bowel move-
ments without tenesmus (Mann, Sketches, p.
280, quote from p. 279).

5. Data and quote from Huntt, “Burling-
ton,” pp. 177-78; Report of the Killed,
Wounded and Missing at Plattsburgh, From
the 6th to the 11th of September 1814, Bran-
nan, Letters, p. 419; Mann, Sketches, p. 153.

6. Quote from George Izard to Secretary
of War, 25 Jun 1814, Izard, Correspondence,
p. 38; Mann, Sketches, pp. 116, 267, 270, and
James Mann to Adjutant General, 17 Aug
1814, p. 267.

7. Mann, Sketches, pp. 145, 271.

8. James Mann to James Tilton, Nov 1814,
Brown, Medical Department, pp. 99-100,
quote from p. 100.

9. James Mann to Elbridge Gerry, 6 Nov
1814, Mann, Sketches, p. 272; James Tilton
to Secretary of War, 10 Feb 1815, RG 107,
M221, roll 66.

10. Mann, Sketches, pp. 125, 262-63,
James Mann to Major General Brown, 1 Feb
1814, p. 266.

11. Mann, Sketches, p. 126; James M. Pha-
len, “Surgeon James Mann's Observations on
Notes to Chapter 9

Battlefield Amputations,” Military Surgeon 87
(1940): 464.

12. Mann, Sketches, pp. 125, 144, quote
from p. 125.

13. James Tilton to Secretary of War, 7
Jun 1814, RG 94, M566, roll 59; Report of a
Case of Amputation, by J. B. Whitridge, M.D.,
Hospital Surgeon’s Mate, 28 Jun 1814, Mann,
Sketches, p. 215; LeBaron to Secretary of War,
8 Jan 1814, and Tilton to Secretary of War,
20 Aug 1814, RG 107, M221, rolls 54 and
66; A List of Deaths . . . at Sackett’s Harbor
From 23d October 1813 to the 20th January
1814 and at Brownville From the Last to the
Present Date, in Washington, National Ar-
chives, Post Revolutionary War Records, Rec-
ord Group 98, book 566.

14. Tilton to Dr. William M. Ross, 7 Jun
1814, and to the Secretary of War, 10 Feb
1815, RG 94, M566, rolls 59, 66; Mann,
Sketches, p. 56; RG 98, book 566.

15. A. Hays to Tilton, 7 Mar 1814, and
Tilton to Secretary of War, 20 Aug 1814 and
10 Feb 1815, RG 107, M221, rolls 59 and 66;
Mann, Sketches, pp. 94, 179; U.S. War De-
partment, Subject Index, General Orders, p.
99.

16. Major General Izard to Secretary of
War, 8 Nov 1814, Cruikshank, Documents,
4: 298.

17. Quote from Major General Izard to
Secretary of War, 26 Nov 1814, Izard, Cor-
respondence, p. 121; Major General Izard to
Secretary of War, 8 Nov 1814, Cruikshank,
Documents, 4: 298.

18. Quote from Eber D. Howe, “Recollec-
tions of a Pioneer Printer,” Buffalo Historical
Society Publications 9 (1906): 398; Clayton
Tiffin to Major General Izard, 6 Dec 1814,
RG 94, M566, roll 59; Scott, Memoirs, 1:
147, 148; Report of Hospital Surgeon Lovell,
1 Aug 1814, Cruikshank, Documents, 4: 452—
53; Louis L. Babcock, The Siege of Fort Erie,
An Episode of the War of 1812 (Buffalo:
Peter Paul Book Co., 1899), p. 44n; W. E.
Horner, “Surgical Sketches,” Medical Exam-
iner and Record of Medical Science, new ser.
8 (1952): 761, 764, 768, 791; Jacob Brown
to Secretary of War, 6 Jul 1814, in Herman
Allen Fay, Collection of the Official Accounts,
in Detail, of All the Battles Fought by Sea and
Land Between the Navy and Army of the

261

United States and the Navy and Army of
Great Britain During the Years 1812, 13, 14,
& 15 (New York, 1817), p. 210.

19. James Tilton to Secretary of War, 20
Aug 1814, RG 107, M221, roll 66; Major
General Jacob Brown reported that 249 were
wounded at the Battle of Chippewa (“Report
of the Killed and Wounded of the Left Divi-
sion Commanded by Major General Brown in
the Action of 5th July 1814, on the Plains of
Chippewa, Upper Canada,” Brannan, Letters,
p- 372).

20. Effner, “Adventures,” pp. 51-52, quote
from p. 52; E. P. Gaines to Secretary of War,
7 and 23 Aug 1814, Brannan, Letters, pp. 384,
399; Mann, Sketches, pp. 70, 111.

21. E. W. Ripley to Brigadier General
Gaines, 17 Aug 1814, Brannan, Letters, p.
392.

22. James Tilton to Secretary of War, 10
Feb 1815, RG 107, M211, roll 66.

23. Nathan Boulden to James Tilton, 9
Oct 1814, RG 94, M566, roll 59.

24. A. Hays to Tilton, 11 Dec 1814 and 2
Jan 1815, RG 94, M566, roll 82, quote from
11 Dec 1814.

25. Tilton to Secretary of War,
1815, RG 94, M566, roll 82.

26. Mann, Sketches, p. 111.

27. Report of Hospital Surgeon Lovell on
the State of Diseases Among the Troops on the
Niagara Frontier During the Campaign of
1814, Cruikshank, Documents, 4: 452.

28. Tilton to Secretary of War,
1815, RG 107, M221, roll 66.

29. Hamersly, Register, pp. 133-34; Regis-
ter, and Rules and Regulations of the Army for
1813, American State Papers: Military Affairs,
1: 386-87.

30. Emory Upton, Military Policy of the
United States (Washington: Government
Printing Office, 1904), p. 126; Albert Kimber-
ley Hadel, “The Battle of Bladensburg,”
Maryland Historical Magazine 1 (1906): 157,
160, 167; Marine, British Invasion, p. 76, and
Report of Lieutenant Colonel Armistead to
Secretary of War, pp. 167, 169; Statement of
General Walter Smith, in John S. Williams,
The Invasion and Capture of Washington
(New York: Harper & Bros., 1857), p. 346;
William H. Winder to Secretary of War, 27
Aug 1814, Brannan, Letters, p. 402; Statement

17 Jan

10 Feb
262

of Dr. Catlett, American State Papers: Mili-
tary Affairs, 1: 584; John M. Stahl, The In-
vasion of the City of Washington, A Disagree-
able Study in and of Military Unpreparedness
(Argos, Ind.: Van Trump Co., 1918), p. 224;
Jay, “Table,” p. 456.

31. Tilton to Secretary of War, 23 Aug
1814, RG 107, M221, roll 66; Office of Ad-
jutant General to W. N. Miner, Esq, 24 Nov
1814, RG 94, M565, roll 5, vol. 3%, p. 208;
A Requisition of Medicine Instruments &c
Wanting for the Military Post & Hospital at
Washington, City, 6 Nov 1813, RG 107,
M222, roll 7; James Blake to Tilton, 5 Nov
1814, and J. O. Tyler to Secretary of War, 19
Oct 1814, RG 94, M566, roll 48, frame 0619,
and roll 54, frame 0166; Office of Adjutant
General to Dr. W. Jones, 19 Jul 1814, RG 94,
M565, roll 5, vol. 3%, p. 85; Constance
McLaughlin Green, Washington, Village and
Capital, 1800-1878 (Princeton, N.J.: Prince-
ton University Press, 1962), p. 3; Register,
and Rules and Regulations of the Army for
1813, American State Papers: Military Affairs,
1: 386.

32. Register, and Rules and Regulations of
the Army for 1813, and Statement of Dr. Cat-
lett, American State Papers: Military Affairs,
1: 396, 585, quote from Report of R. M.
Johnson to the House of Representatives, 1:
530; Hamersly, Register, pp. 95, 147.

33. Statement of Dr. Catlett, American
State Papers: Military Affairs, 1: 583. Cat-
lett’s status at this time is not clear. He wished
to resign as surgeon of the 1st Infantry and,
although his resignation appears to have been
rejected initially, it was accepted in mid-June
1814. By early August, however, Catlett had
not yet been notified of this fact and by the
time he received the notice, he had begun to
believe that his reputation had been blackened
and asked to be kept in the Army until he
could clear his name. In September he ac-
cepted another appointment with the Army.
Hanson Catlett to Lieutenant Colonel Nicho-
las, 4 Jun 1814, to Secretary of War, 9 Aug
1814, and to Acting Secretary of War, 9 Sep
1814, RG 94, M566, roll 39, frames 0634—
0635, 0638, 0640-0642, 0648; Office of Ad-
jutant General to Catlett, 15 Jun 1814, RG
94, M565, roll 5, vol. 3%, p. 35.

34. Catlett to Adjutant and Inspector Gen-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

eral, 2 Sep 1814, RG 107, M221, roll 60;
Catlett Statement, American State Papers:
Military Affairs, 1: 584; Marine, British In-
vasion, p. 174; Catlett to Secretary of War, 30
Aug 1814, RG 94, M566, roll 39, frame 0646;
Statement of Dr. Catlett, Armstrong, War of
1812, 2: 226; Hadel, “Bladensburg,” p. 167;
Office of Adjutant General to Catlett, 12 Sep
1814, RG 94, M565, roll 5, vol. 314, p. 145.

35. Green, Washington, p. 51; Albert Alle-
man, “Experiences of an American Physician
at the Capture of Washington by the British in
1814,” Medical Library and Historical Jour-
nal 4 (1906): 187; Ewell, Medical Companion,
pp. 690-91.

36. Office of Adjutant General to Dr. A.
Elzy, 17 Jan 1815, RG 94, M565, roll 5, vol.
3%2, p. 295, quote from Office of Adjutant
General to H. Huntt, 13 Jan 1815, p. 292;
Tilton to Secretary of War, 10 Feb 1815, RG
107, M221, roll 66.

37. Register, and Rules and Regulations of
the Army for 1813, and A Report of the Army,
Its Strength and Distribution, Previous to the
Ist of July 1814, American State Papers:
Military Affairs, 1: 387, 535; Nathaniel Clai-
borne, Notes on the War in the South (New
York: Arno Press & The New York Times,
1971 reprint of 1819 edition), p. 47.

38. Andrew Jackson to Secretary James
Monroe, 27 Dec 1814, in John S. Bassett, ed.,
Correspondence of Andrew Jackson, 7 vols.
(Washington: Carnegie Institution of Washing-
ton, 1926-35), 2: 127; Stanley Clisby Arthur,
The Story of the Battle of New Orleans (New
Orleans: Louisiana Historical Society, 1915),
p. 248; William McCarty, History of the
American War of 1812, From the Commence-
ment Until the Final Termination . . . , 2d
ed. (Freeport, N.Y.: Books for Libraries
Press, 1970 reprint of 1816 edition), p. 229;
A. S. Colyar, Life and Times of Andrew Jack-
son, Soldier, Statesman, President, 2 vols.
(Nashville, Tenn.: Marshall & Bruce Co.,
1904), 1: 239; Arsene Lacarriere Latour,
Historical Memoir of the War in West Florida
and Louisiana in 1814-15, trans. H. P. Nugent
(Gainesville: University of Florida Press,
1964 version of 1816 original), p. 45.

39. Latour, Memoir, p. 148; Andrew Jack-
son to Secretary of War, 19 Jan 1815, Bassett,
Jackson, 2: 148.
Notes to Chapter 9

Reports on American casualties vary, but
from 55 to 62 were killed and from 175 to
185 wounded. Report of the American Loss
in Several Actions Below New Orleans, Bran-
nan, Letters, p. 461; Bassett, Jackson, 2:
143n; Arthur, New Orleans, p. 247; Latour,
Memoir, pp. lix, 122-23, 135; Howell Tatum,
Major Howell Tatum’s Journal . . . , ed. John
Spencer Bassett (Northampton, Mass.: Smith
College Studies in History, 1922), pp. 117-18,
122, 130.

40. Hamersly, Register, pp. 84, 133, 134;
Register, and Rules and Regulations of the
Army for 1813, American State Papers: Mili-
tary Affairs, 1: 387, 391.

41. Register, and Rules and Regulations of
the Army for 1813, American State Papers:
Military Affairs, 1: 418.

42. Quotes from A. G. Goodlet to Secretary
of War, Jun 1815, RG 107, M221, roll 61; O.
H. Spencer to Secretary of War, 10 May 1814,
RG 107, M221, roll 66.

43. Secretary of War to Commanding Offi-
cers at New Orleans, 17 Jun 1815, RG 107,
M6, roll 8, p. 166.

44. Quote from Statement of David C. Kerr,
Hosp. Surgeon, Bassett, Jackson 2: 203; James
Parton, Life of Andrew Jackson, 3 vols. (Bos-
ton: Fields, Osgood & Co., 1870), 2: 121;
American State Papers: Claims, 5 Feb 1790-3
Mar 1823, p. 752; Arthur, New Orleans, pp.
81, 240-41; Alcée Fortier, A History of Loui-
siana, 4 vols. (New York: Manzi, Joyant, &
Co., 1904), 3: 167.

45. Bassett, Jackson, 2: 163n; Office of Ad-
jutant General to Dr. David C. Kerr, 4 Feb
1813, RG 94, M565, roll 4, vol. 3, p. 93;
Tilton to Secretary of War, 10 Feb 1815, RG
107, M221, roll 66.

46. Quote from Stephen Simpson to George
Simpson, 9 Jan 1815, American Historical Re-
view 2 (1896): 268; Daniel Patterson to Sec-
retary of Navy, 27 Jan 1815, and General
Orders, 21 Jan 1815, Brannan, Letters, pp.
462-63, 480; Andrew Jackson to Secretary
Monroe, 27 Dec 1814, Bassett, Jackson, 128;
Colonel Bartholomew Shaumburg to William
C. C. Claiborne, 30 Oct 1815, in W. C. C.
Claiborne, Official Letter Books of W. C. C.
Claiborne, 1801-1816, ed. Dunbar Rowland,
6 vols. (Jackson, Miss.: State Dept. of Ar-
chives and History, 1917), 6: 380; Eron Opha

263

Rowland, Andrew Jackson's Campaign Against
the British, or the Mississippi Territory in the
War of 1812 . . . (Freeport, N.Y.: Books
for Libraries Press, 1971 reprint of 1926 edi-
tion), pp. 81, 81n; Latour, Memoir, p. 184;
Office of Adjutant General to Dr. O. H. Spen-
cer, 10 Jul 1814, and Francis LeBaron to Ad-
jutant and Inspector General, 20 Dec 1814,
RG 94, M565, roll 5, vol 3V2, p. 82; M566,
roll 12; Hamersly, Register, p. 272; Jane Lucas
de Grummond, The Baratarians and the Battle
of New Orleans (Baton Rouge: Louisiana
State University Press, 1961), p. 100.

47. Latour, Memoir, pp. 163, 177, 225,
quote from p. 225; Parton, Jackson, 2: 221,
229-30; L’Ami des Lois, 16 Jan 1815, in Reed
Adams, “New Orleans and the War of 1812,”
Louisiana Historical Quarterly 17 (1934):
362; Arthur, New Orleans, pp. 219-20; Alex-
ander Walker, Jackson and New Orleans . . .
(New York: J. C. Derby, 1856), p. 347; John
Henry Cooke, A Narrative of Events in the
South of France and of the Attack on New
Orleans, in 1814 and 1815 (London: T. & W.
Boone, 1835), pp. 263-64; Resolution of the
Legislature of Louisiana, Fortier, Louisiana,
3: 167.

48. Andrew Jackson to Major-General
Lambert, 8 Jan 1815, Bassett, Jackson, 2: 134.

49. Quote from Andrew Jackson to Col
Robert Hays, 17 Feb 1815, Bassett, Jackson
2: 172; Parton, Jackson 2: 226; General
Orders, D. Parker, Adjutant and Inspector
General, 6 Jan 1815, Niles’ Weekly Register
(Baltimore) 7: 317.

50. General Orders, Headquarters 7th Mili-
tary District, 21 Jan 1815, Brannan, Letters,
p. 480.

51. Prucha, Guide, p. 94; Hamersly, Regis-
ter, p. 134; Tilton to Secretary of War, 20
Aug 1814, RG 107, M221, roll 66.

52. Quote from Tilton to Secretary of War,
20 Aug 1814, RG 107, M221, roll 66; Joseph
Wheaton, Appeal to the Senate and House of
Representatives of the United States of Amer-
ica (District of Columbia, 1820), p. 29.

53. Wheaton, Appeal, pp. 19-20, 21-22,
quote from p. 19.

54. Tilton to Secretary of War, 20 Aug
1814, RG 107, M221, roll 66; Register, Rules
and Regulations of the Army for 1813, Amer-
ican State Papers: Military Affairs, 1: 386.
264

CHAPTER 10

1. William Eustis to Secretary of War, 21
Mar 1815, RG 94, M566, roll 12.

2. Quote and data from Crawford to Chair-
man of Military Committee, 27 Dec 1815,
American State Papers: Military Affairs, 1:
636; Army Register for 1816, American State
Papers: Military Affairs, 1: 628, 635; Inger-
soll, War Department, p. 216; Henry C. Cor-
bin and Raphael P. Thian, eds., Legislative
History of the General Staff of the Army of
the United States (Washington: Government
Printing Office, 1901), p. 409; Francis Le-
Baron to William Eustis, 16 Mar 1815, Eustis
Papers; James Mann to James Tilton, 18 Mar
1815, Francis LeBaron to Secretary of War,
18 Mar 1815, James Tilton to Secretary of
War, 28 Apr 1815, James Mann to President
Madison, 7 Sep 1815, and James Mann to
Colonel Conner, 14 Dec 1815, RG 94, M566,
rolls 75, 82.

3. Unless otherwise indicated, all material in
this section is based on Ganoe, U.S. Army;
Spaulding, Army; and Weigley, Army. Also
consulted for the preceding paragraph were
John Caldwell Calhoun, The Papers of John
C. Calhoun, ed. W. Edwin Hemphill, 2 vols.
to date (Columbia: University of South Caro-
lina Press for the South Carolina Society,
1963), 2: Ixi; Corbin and Thian, Legislative
History, p. 409; Army Register for 1816,
American State Papers: Military Affairs, 1:
635.

4. Quote from “Review of Circular Letter
of Benjamin Waterhouse to His Surgeons in
the 2nd Military District, September 1817,”
Medical Repository 19 (1818): 395-96; Cor-
bin and Thian, Legislative History, p. 410;
Bayne-Jones, Preventive Medicine, pp. 79-80.

5. Tilton to Secretary of War, 28 Apr and
8 May 1815, quote from Joseph Eaton to
James Tilton, 22 Apr 1815, RG 94, M566,
roll 82; Office of the Adjutant General to J.
H. Sackett, 13 Jan 1816, RG 94, M565, roll
5, vol. 3V2, pp. 491-92; Register for 1816,
American State Papers: Military Affairs, 1:
627-28, 631-32, 633, 634, 635.

6. Quote from James Tilton to Secretary of
War, 28 Apr 1815, RG 94, M566, roll 82;
James Mann to President Madison, 7 Sep
1815, Mann to Secretary of War, 14 Apr 1815,

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Mann to Colonel Conner, 14 Dec 1815,
Francis LeBaron to Secretary of War, 18 Mar
1815, Morgan Lewis and Jabez C. [illegible]
to Secretary of War, 21 Mar 1815, RG 94,
M566, roll 75; Office of Adjutant General to
T. Watkins, 11 May 1816, RG 94, M565, roll
5, vol. 4, p. 30.

7. Francis LeBaron to Adjutant and In-
spector General, 18 Apr 1815, RG 94, M566,
roll 12; Francis LeBaron to Secretary of War,
5 and 10 Feb, 3 Apr, and 6 Jun 1815, RG
107, M221, rolls 63, 64; George Graham to
Francis LeBaron, 27 Jul 1815, RG 107, M6,
roll 8, pp. 243-44.

8. Quotes from Francis LeBaron to Ad-
jutant and Inspector General, 28 May 1816,
RG 94, M566, roll 12; and to Secretary of
War, 8 May 1817, RG 107, M221, roll 74.

9. Francis LeBaron to Secretary of War, 7
Mar 1815, and Benjamin Waterhouse to Sec-
retary of War, 12 Jul 1815, RG 107, M221,
rolls 63, 67; Joseph Lovell to Adjutant Gen-
eral, 30 Oct 1817, RG 94, M566, roll 98;
Office of Adjutant General to Henry Huntt,
15 Jun 1815, RG 94, M565, roll 5, vol. 3V2,
p. 386.

10. Francis LeBaron to Secretary of War,
13 Jan 1816, to Adjutant and Inspector Gen-
eral, 31 Mar 1817, and to Inspector General,
19 Jun 1817, RG 94, M566, roll 12; LeBaron
to Secretary of War, 26 Jul 1816, RG 107,
M221, roll 70.

11. Francis LeBaron to Secretary of War,
28 May and 26 Jul 1816, RG 107, M221, roll
70; Secretary of War to Dr. W. P. Jones, 14
Jan 1815, RG 107, M6, roll 8, pp. 25-26.

12. Quote from Francis LeBaron to Secre-
tary of War, 14 Sep 1816, RG 107, M221,
roll 70; LeBaron to Secretary of War, 6 Jun
1815, and to Adjutant and Inspector General,
28 May 1816, RG 107, M221, rolls 12, 64;
James Cutbush to Adjutant General, 5 Jun
1816, RG 94, M566, roll 41.

13. Quote from Francis LeBaron to Ad-
jutant and Inspector General, 7 Nov 1816,
RG 94, M566, roll 12; LeBaron to Secretary
of War, 26 Jul and 14 Sep 1816, RG 107,
M221, roll 70.

14. Secretary of War to LeBaron, 5 Feb
1817, RG 107, M6, roll 8, p. 243.

15. Francis LeBaron to Secretary of War,
7 Mar 1815, RG 107, M221, roll 63, quote
Notes to Chapter 10

from James Tilton to Secretary of War, 10
Feb 1815, roll 66; Office of Adjutant General
to Dr. J. H. Sackett, 23 Oct 1817, and to Dr.
F. Swift, 22 Oct 1817, RG 94, M565, roll 5,
vol. 4, p. 262.

16. James Tilton to Secretary of War, 17
Jan 1815, RG 94, M566, roll 82, quote from
James Mann to Secretary of War, 14 Apr
1815, roll 75; Office of Adjutant General to
Henry Huntt, 7 Feb and 15 Jun 1815, RG 94,
M565, roll 5, vol. 3v2, pp. 318, 386.

17. Remarks on the Sick Report of the
Northern Division for the Year Ending 30 Jun
1817, Brown, Medical Department, p. 102.

18. I. M. McKay to Maj Perrin Willis, 30
Oct 1817, RG 94, M566, roll 98.

19. Remarks on the Sick Report of the
Northern Division for the Year Ending 30
Jun 1817, Brown, Medical Department, p. 102.

20. Francis LeBaron to Secretary of War,
25 Apr and 4 May 1813, RG 107, M221, roll
54.

21. Quote from George Izard to Secretary
of War, 1 Jun 1814, Izard, Correspondence,
pp. 21-22; James Tilton to Secretary of War,
12 Jul 1813, RG 107, M221, roll 57.

22. General Committee of Defense, Obser-
vations; Heustis, Diseases of Louisiana, pp.
130-31; James Mann to Secretary of War, 14
Apr 1815, RG 94, M566, roll 75; Brown,
Medical Department, p. 105.

23. Brown, Medical Department, p. 104.

24. James Tilton to Secretary of War, 20
Aug 1814, RG 107, M221, roll 66.

25. Mann, Sketches, pp. 122, 124.

26. Quote from RG 98, vol. 683, 1st and
9th Regiments; Brown, Medical Department,
p. 102; RG 98, vols. 680, 683; Samuel Akerly,
“Medical Topography of the Military Posi-
tions in the Third United States Military Dis-
trict: Together With a Summary Report on the
Diseases of the Army . . . ,” Medical Reposi-
tory, 2d ser. 3 (1817): 294.

27. Heustis, Diseases of Louisiana, p. 138.

28. Brown, Medical Department, pp. 88,
102, 103, quote from p. 88; Mann, Sketches,
p. 76; Heustis, Diseases of Louisiana, p. 136;
Benjamin Waterhouse, Circular Letter From
Dr. Benjamin Waterhouse to the Surgeons of
the Different Posts in the Second Military
Department (Cambridge, Mass., 1817), pp.
12-13.

265

29. Waterhouse, Letter, pp. 8-9, 10, 15,
quotes from pp. 10, 15; Heustis, Diseases of
Louisiana, pp. 136, 137.

30. Mann, Sketches, pp. 130-31.

31. Waterhouse, Letter, p. 16.

32. Quote from Waterhouse, Letter, p. 14;
Heustis, Diseases of Louisiana, p. 136.

33. Heustis, Diseases of Louisiana, pp. 138,
139, quote from p. 139 (Heustis’s preferences
in fruit may seem exotic, but, of course, he
was writing of his experience in Louisiana);
Waterhouse, Letter, pp. 12, 17, 19-20.

34. Mann, Sketches, p. 76.

35. Quote from Heustis, Diseases of Louisi-
ana, p. 114; Warren, Mercurial Practice, pp.
45-46, 92. The term typhoid has apparently
often been used to mean “resembling typhus”
[see first definition of typhoid in Dorland’s
Illustrated Medical Dictionary, 24th ed. (Phila-
delphia: W. B. Saunders Co., 1965), p. 1640]
and the two diseases were not clearly distin-
guished until 1837. [See Hume, Victories, pp.
99-100; and Leonard G. Wilson, “The Clini-
cal Definition of Scurvy and the Discovery of
Vitamin C,” Journal of the History of Medi-
cine and Allied Sciences 30 (1975): 59.]

36. Purcell Report, Mann, Sketches, p. 153.
Sordes is “The dark-brown, foul matter which
collects on the lips and teeth in low fevers”
(Dorland, p. 1406).

37. Data and quote from Waterhouse, Let-
ter, p. 5; Brown, Medical Department, p. 105;
James Thacher, American Modern Practice;
Or, a Simple Method of Prevention and Cure
of Diseases . . . (Boston: Ezra Read, 1817),
p: 173.

38. Joseph Lovell Report, Mann, Sketches,
pp. 163-64.

39. Quote from Joseph Lovell Report,
Mann, Sketches, p. 103; Warren, Mercurial
Practice, p. 98.

40. Thomas, Modern Practice, p. 43.

41. Mann, Sketches, pp. 68, 128, 160-61,
quote from p. 90.

42. Brown, Medical Department, pp. 102,
104-5, quote from p. 102; Army Register for
1816, American State Papers: Military Affairs,
1: 63S.

43. Mann, Sketches, p. 129.

44. Hanson Catlett to Major McClelland,
17 Jan 1815, RG 94, M566, roll 67.

45. Waterhouse, Letter, p. 22.
266

46. Mann, Sketches, pp. 186-98.

47. Waterhouse, Letter, pp. 14, 15.

48. Mann, Sketches, pp. 130-31, 134, 136,
quotes from pp. 134, 136.

49. Mann, Sketches, pp. 80-81.

50. Quotes from Waterhouse, Letter, pp. 6—
7; Mann, Sketches, pp. 88-89.

51. Mann, Sketches, p. 206; “Diseases of
the Army of the Third United States Military
District,” Medical Repository, new ser. 3
(1817): 407; John Shaw, “Narrative of John
Shaw: Dictated to Lyman C. Draper,” Wis-
consin State Historical Society Publications 2
(1855): 217.

52. Horner, “Surgical Sketches,” 9: 1, 2.

53. Horner, “Surgical Sketches,” 9: 3, 71,
quote from p. 71.

54. Horner, “Surgical Sketches,” 9: 78.

55. Horner, “Surgical Sketches,” 9: 7.

56. Barton became the first Surgeon-General
of the Navy in 1842. William Paul Crillon
Barton, A Treatise Containing a Plan for the
Internal Organization and Government of
Marine Hospitals in the United States; To-
gether With Observations on Military and Fly-
ing Hospitals . . . , 2d ed. (Philadelphia,
1817), pp. 131, 132, quotes from pp. 131, 132;
Mann, Sketches, pp. 240-41.

57. Mann, Sketches, p. 240.

58. Mann, Sketches, pp. 238-39, 243, quote
from p. 238.

59. Mann, Sketches, p. 250.

60. Mann, Sketches, pp. 244, 246; Brown,
Medical Department, p. 106.

61. Mann, Sketches, pp. 235-36; Office of
the Adjutant General to James Mann, 16 Jul,
14 Nov 1816, and to Dr. W. P. C. Barton, 15
Oct 1816, RG 94, M565, roll 5, vol. 4, pp. 66,
117, 124.

APPENDIXES

1. Unless otherwise indicated, material in
this appendix is based on Gibson, Otto. Wash-
ington’s General Orders, 20 Nov 1777, Fitz-
patrick, Washington, 10: 88; Weedon, Val-
ley Forge, p. 135; Robert Kirkwood, The
Journals and Order Book of Captain Robert
Kirkwood of the Delaware Regiment of the
Continental Line, ed. Joseph Brown Turner

THE ARMY MEDICAL DEPARTMENT,

1775-1818

(Port Washington, N.Y.: Kennikat Press,
1910), p. 248; Shippen report of 24 Nov 1777,
Duncan, Medical Men, p. 239.

2. Quote from Sproat, “Extracts,” p. 443,
Rev Henry Melchior Miihlenberg to Halle
Fathers in Germany, Gibson, Otto, pp. 153-54.

3. Duncan, Medical Men, p. 226; Jordan,
“Returns,” pp. 36-38; A Return of the
Wounded Belonging to Different Regiments
and Their Respective Companies, Lancaster,
11 Oct 1777, Alison Papers; Gen George
Washington to Lt Col William Stephens Smith,
27 Jan 1778, Fitzpatrick, Washington, 10:
356-57; Ebenezer David, A Rhode Island
Chaplain in the Revolution, Letters of Ebe-
nezer David to Nicholas Brown, 1775-1778,
eds. Jeannette D. Black and William Greene
Roelker (Providence: The Rhode Island So-
ciety of the Cincinnati, 1949), p. 75; Report
of Brig Gen Lachlan McIntosh, 26 Apr 1778,
RG 93, M246, roll 135, folder 3-1, item 10.

4. Butterfield, Letters of Rush, 1: 158.

5. Griffenhagen, Drug Supplies, p. 127;
James Craik to Jonathan Potts, 7 Apr 1778,
Gibson, Otto, p. 162; Heiges, “Letters,” pp.
74, 77; Shippen report of 24 Nov 1777,
Duncan, Medical Men, p. 239. Duncan’s book
contains neither footnotes nor bibliography
and the original of this report has not been
located. His version of the document lists
“Mendham” rather than Manheim, but be-
cause it is not likely that the Mendham hos-
pital was still open, because, although no state
is mentioned, the hospital is listed with those
in Pennsylvania, and because Duncan has been
known to misread the city names in eighteenth
century reports, it seems obvious that Man-
heim is the name intended by Shippen.

6. Weedon, Valley Forge, pp. 109-10; Ship-
pen report of 24 Nov 1777, Duncan, Medical
Men, p. 239.

7. Middleton, “Valley Forge,” p. 485.

8. Jordan, “Returns,” p. 40; Radbill, “Ali-
son,” p. 252; A Return of the Sick & Wounded
in the Hospital at Plumstead, 10 Dec 1777,
Alison Papers; Shippen, Just Account.

9. Sproat Journal, Gibson, Otro, p. 329.

10. Sproat Journal, Gibson, Otto, p. 326;
Report of Brig Gen Lachlan McIntosh, 27
Apr 1778, RG 93, M246, roll 135, folder 3-1,
item 11.
Notes to Appendixes

11. Report of Brig Gen Lachlan McIntosh,
26 Apr 1778, RG 93, M246, roll 135, folder
3-1, item 10.

12. Quote from Report of Brig Gen Lachlan
Mcintosh, 25 Apr 1778, RG 93, M246, roll
135, folder 3-1, item 10; Heiges, “Letters,”

. 77.

P 13. Matthew Irwine to Jonathan Potts, 22
Mar 1778, Potts Papers, 4: 423; Report of
Brig Gen Lachlan McIntosh, 27 Apr 1778,
RG 93, M246, roll 135, folder 3-1, item 11;
Sproat Journal, Gibson, Oto, p. 328.

14. Washington's General Orders, 17 Jun

267

1777, Fitzpatrick, Washington, 8: 251; Ac-
counts of John Dunn, 1777-78, RG 93, M859,
roll 124, frame 989, item 035501.

15. Washington’s General Orders, 17 Jun
1777, Fitzpatrick, Washington, 8: 257; Ella W.
Mockridge, Our Mendham (Ann Arbor, Mich.,
1961), p. 56; Mendham, New Jersey, Mayor's
Tercentenary Committee, The Mendhams,
(Brookside, N.J., 1964), p. 32.

16. Butterfield, Letters of Rush, 1: 167n;
Benjamin Rush to Julia Rush, 10 Nov 1777,
and Benjamin Rush to James Searle, 19 Nov
1777, Butterfield, Letters of Rush, 1: 166.
c¥

a

~

-

Bibliography

Ackerknecht, Erwin Heinz. Malaria in the
Upper Mississippi Valley, 1760-1900. Balti-
more: Johns Hopkins Press, 1945.

. A Short History of Medicine. New
York: Ronald Press Co., 1955.

Adams, John. Letters of John Adams Ad-
dressed to His Wife. Edited by Charles Fran-
cis Adams. 2 vols. Boston: Charles C.
Little and James Brown, 1841.

Adams, Randolph Greenfield, and Peckham,
Howard H., eds. Lexington to Fallen Tim-
bers 1775-1794. Ann Arbor: University of
Michigan Press, 1942.

Adams, Reed. “New Orleans and the War of
1812.” Louisiana Historical Quarterly 16
(1933): 221-34, 479-503, 681-703; 17
(1934): 169-82, 349-63, 502-23.

Adams, Samuel. The Writings of Samuel
Adams. Edited by Harry Alonzo Cushing.
4 vols. New York: Octagon Books, 1968.

Adams, T. R. “The Medical and Political
Activities of Dr. James Tilton.” Annual
Report of the John Carter Brown Library
(Brown University and the Colonial Society
of Massachusetts, Providence, R.I.) 7
(1972): 30-32.

Aiken, John. Thoughts on Hospitals. London:
Joseph Johnson, 1771.

Akerly, Samuel. “Medical Topography of the
Military Positions in the Third United States
Military District: Together With a Summary
Report on the Diseases of the Army . ...”
Medical Repository, 2d ser. 3 (1817): 293-
300, 405-7.

Alison Papers. See under Philadelphia, Pa.

Alleman, Albert. “Experiences of an American
Physician at the Capture of Washington by
the British in 1814.” Medical Library and
Historical Journal 4 (1906): 185-88.

The American Revolution 1775-1783: An At-
las of 18th Century Maps and Charts:

 

Theaters of Operations. Washington: Gov-
ernment Printing Office, 1972.

American State Papers. See under U.S. Con-
gress.

Amory, Thomas Coffin. The Military Services
and Public Life of Major-General John
Sullivan of the American Revolutionary
Army, Port Washington, N.Y.: Kennikat
Press, 1968 reprint of 1868 edition.

Anderson, Fanny J. “Medical Practices During
the War of 1812.” Bulletin of the History of
Medicine 16 (1944): 261-75.

Anderson, Joseph, ed. The Town and City of
Waterbury, Connecticut, From the Abo-
riginal Period to the Year Eighteen Hundred
and Ninety-Five. 2 vols. New Haven:
Price & Lee Co., 1896.

Angelakos, Peter. “The Army at Middlebrook
1778-1779.” New Jersey Historical Society
Proceedings 70 (1952): 97-120.

Applegate, Howard Lewis. “The American
Revolutionary War Hospital Department.”
Military Medicine 126 (1961): 296-306.

. “The Medical Administrators of the

American Revolutionary Army.” Military

Affairs 25 (1961): 1-10.

. “Preventive Medicine in the American

Revolutionary Army.” Military Medicine

126 (1961): 379-82.

. “Remedial Medicine in the American
Revolutionary Army.” Military Medicine
126 (1961): 450-53.

Armstrong, John. Notices of the War of 1812.
2 vols. New York: Wiley & Putnam, 1840.

Arnold, Benedict. The Present State of the
American Rebel Army, Navy and Finances,
Transmitted to the British Government, Oc-
tober 1780.

Arthur, Stanley Clisby. The Story of the
Battle of New Orleans. New Orleans:
Louisiana Historical Society, 1915.

Ashburn, P. M. 4 History of the Medical

 

 

 
270

Department of the United States Army.
Boston: Houghton Mifflin Co., 1929.

Atherton, William. Narrative of the Suffering
& Defeat of the Northwestern Army Under
General Winchester . . . . Frankfort, Ky.,
1842.

Babcock, Louis L. The Siege of Fort Erie, An
Episode of the War of 1812. Buffalo, N.Y.:
Peter Paul Book Co., 1899.

. The War of 1812 on the Niagara
Frontier. Buffalo, N.Y.: Buffalo Historical
Society, 1927.

Ballagh, James Curtis, ed. The Letters of
Richard Henry Lee. 2 vols. New York:
Da Capo Press, 1970 reprint of 1911-14
edition.

Bartlett, Josiah. A Dissertation on the Progress
of Medical Science in the Commonwealth of
Massachusetts. Boston: T. B. Wait and Co.,
1810.

Barton, William Paul Crillon. 4 Treatise Con-
taining a Plan for the Internal Organization
and Government of Marine Hospitals in the
United States; Together With Observations
on Military and Flying Hospitals, and a
Scheme for Amending and Systematizing
the Medical Department of the Navy. 2d
ed. Philadelphia, 1817.

Bassett, John S., ed. Correspondence of An-
drew Jackson. 7 vols. Washington: Car-
negie Institution of Washington, 1926-35.

Bayne-Jones, Stanhope. The Evolution of Pre-
ventive Medicine in the United States Army,
1607-1939. Washington: Government Print-
ing Office, 1968.

Beall, William Kennedy. “Journal of William
K. Beall, July-August 1812.” Reprinted
from American Historical Review 17
(1912): 783-808.

Beatty, Joseph M., Jr. “Letters From Conti-
nental Officers to Doctor Reading Beatty,
1781-1788.” Pennsylvania Magazine of
History and Biography 54 (1930): 155-74.

Beaumont, William. William Beaumont’s For-
mative Years: Two Early Notebooks, 1811-
1821. Edited by Genevieve Miller. New
York: Henry Schuman, 1946.

Beck, Herbert H. “The Military Hospital at
Lititz, 1777-1778.” Lancaster County His-
torical Society Papers 23 (1919): 5-14.

Beck, James A. Bethlehem and Its Military
Hospital, An Address Delivered at the Un-

 

THE ARMY MEDICAL DEPARTMENT,

 

1775-1818

veiling of a Tablet Erected by the Pennsyl-
vania Society of the Sons of the Revolution,
June 19, 1897, in Memory of the Soldiers
of the Continental Army, Who Suffered and
Died at the Military Hospital at Bethlehem,
Pennsylvania. Printed by the Society.

Beck, John B. Medicine in the American
Colonies: An Historical Sketch of the State
of Medicine in the American Colonies,
From Their First Settlement to the Period
of the Revolution. Albuquerque, N. Mex.:
Horn & Wallace, 1966 reprint of 1850 edi-
tion.

Beebe, Lewis. Journal of Dr. Lewis Beebe. The
New York Times & Arno Press, 1971.

Beirne, Francis F. War of 1812. New York:
E. P. Dutton & Co., 1949.

Bell, Whitfield Jenks, Jr. John Morgan, Conti-
nental Doctor. Philadelphia: University of
Pennsylvania Press, 1965.

. “Medical Practice in Colonial Ameri-

ca.” Bulletin of the History of Medicine 31

(1957): 442-53.

“Philadelphia Medical Students in
Europe, 1750-1800.” Pennsylvania Maga-
zine of History and Biography 67 (1943):
1-29.

Bernardo, C. Joseph, and Bacon, Eugene R.
American Military Policy: Its Development
Since 1775. Harrisburg: Stackpole, 1955.

Bethlehem of Pennsylvania: The First One
Hundred Years: 1741 to 1841. Bethlehem,
Pa., 1968.

Bett, W. R. “John Warren (1753-1815),
Soldier, Anatomist and Surgeon.” Medical
Press 230 (1953): 137.

Bick, Edgar M. “French Influences on Early
American Medicine and Surgery.” Journal
of the Mount Sinai Hospital 24 (1957):
499-509.

Bill, Alfred Hoyt. Valley Forge: The Making
of an Army. New York: Harper & Bros,
1952.

Billings, John S. “The History and Literature
of Surgery.” In System of Surgery, vol. 1,
edited by Frederic Shephard Dennis. Phila-
delphia: Lea Bros. & Co., 1895.

Billroth, Theodor. “Historical Studies on the
Nature and Treatment of Gunshot Wounds
From the Fifteenth Century to the Present
Time.” Translated by C. P. Rhoads. Yale

 
Bibliography

Journal of Biology and Medicine 4 (1931-
32): 3-36, 119-48, 225-57.

Blake, John Ballard. Benjamin Waterhouse
and the Introduction of Vaccination, a Re-
appraisal. Philadelphia: University of Penn-
sylvania Press, 1957.

“Diseases and Medical Practice in

Colonial America.” In “Symposium on the

History of American Medicine.” Interna-

tional Record of Medicine 171 (1958):

350-63.

. Public Health in the Town of Boston,
1630-1822. Cambridge: Harvard University
Press, 1959.

Blanco, Richard L. Physician of the American
Revolution: Jonathan Potts. New York:
Garland STPM Press, 1979.

. To author, letter, 22 April 1975.

Bland, Theodorick. The Bland Papers, Being
a Selection From the Manuscripts of Colonel
Theodorick Bland, Jr., of Prince George
County, Virginia, to Which Are Prefixed
an Introduction, and a Memoir of Colonel
Bland. Edited by Charles Campbell. 2 vols.
Petersburg, Va.: E. & J. C. Ruffin, 1840-
43,

Blanton, Wyndham Bolling. Medicine in Vir-
ginia in the Eighteenth Century. Richmond:
Garrett & Massie, 1931.

Bouvet, Maurice. Le Service de santé francais
pendant la guerre d'indépendance des
Etats-Unis. Paris: Hippocrate, 1933.

Bowman, Allen. Morale of the American
Revolutionary Army. Washington: Ameri-
can Council on Public Affairs, 1943.

Boyd, Mark F. “An Historical Sketch of the
Prevalence of Malaria in North America.”
American Journal of Tropical Medicine 21
(1941): 223-44.

Boyer, John. “Daily Journal of Wayne's Cam-
paign.” American Pioneer 1 (1842): 315-
22, 351-57.

Bradford, S. Sydney. “Hunger Menaces the
Revolution, December 1779-January 1780.”
Maryland Historical Magazine 61 (1966):
1-23.

Brady, Cyrus Townsend. American Fights and
Fighters: Stories of the First Five Wars of
the United States From the War of the
Revolution to the War of 1812. New York:
McClure, Phillips & Co., 1900.

Brannan, John. Official Letters of the Military

 

 

 

271

and Naval Officers of the United States
During the War With Great Britain. Wash-
ington: Way & Gideon, 1823.

Brasch, Frederick E. “The Royal Society of
London and Its Influence Upon Scientific
Thought in the American Colonies.” Sci-
entific Monthly 33 (1931): 336-55, 448-69.

Brocklesby, Richard. Oeconomical and Medi-
cal Observations, in Two Parts, From the
Year 1758 to the Year 1763, Inclusive . . . .
London: T. Becket and P. A. De Hondt,
1764.

Brown, Harvey E. The Medical Department
of the United States Army From 1775 to
1873. Washington: The Surgeon General's
Office, 1873.

Brown, Samuel R. An Authentic History of
the Second War for Independence . . . . 2
vols. Auburn, N.Y.: J. G. Hathaway, 1815.

Buchan, William. Domestic Medicine; Or, the
Family Physician . . . . 2d American ed.
Philadelphia: Joseph Crukshank, 1774.

. Observations Concerning the Diet of

the Common People . . . . London: A. Stea-

han, T. Cadell, Jr., and W. Davies, J. Bal-

four and W. Creich, 1797.

. Observations Concerning the Preven-
tion and Cure of the Venereal Disease In-
tended to Guard the Ignorant and Unwary
Against the Baneful Effects of That Insidi-
ous Malady. Dublin: P. Wogan, J. Millikin,
W. Sleater, J. Rice, P. Moore, 1796.

Burnett, Edmund Cody, ed. Letters of Mem-
bers of the Continental Congress. 8 vols.
Washington: Carnegie Institution of Wash-
ington, 1921-36.

Bush, Lewis Potter. The Delaware State Medi-
cal Society and Its Founders in the Eight-
eenth Century. New York, 1886.

Butterfield, Lyman H. “Benjamin Rush: A
Physician As Seen in His Letters.” Bulletin
of the History of Medicine 20 (1946):
138-56.

Butterfield, Lyman H., ed. Letters of Benja-
min Rush: Memoirs of the American Phil-
osophical Society. 2 vols. Princeton: Prince-
ton University Press, 1951.

Calhoun, John Caldwell. The Papers of John
C. Calhoun. Edited by W. Edwin Hemphill.
2 vols. to date. Columbia: University of
South Carolina Press for the South Caro-
lina Society, 1963.

 

 
272

Callan, John F. The Military Laws of the
United States Relating to the Army, Vol-
unteers, Militia, and to Bounty Lands and
Pensions, From the Foundation of the Gov-
ernment to the Year 1863. Philadelphia:
George W. Childs, 1863.

Campfield, Jabez. “Diary of Dr. Jabez Camp-
field, Surgeon in ‘Spencer’s Regiment,” While
Attached to Sullivan’s Expedition Against
the Indians From May 23d to Oct 2d, 1779.”
New Jersey Historical Society Proceedings,
2d ser. 3 (1873): 115-36.

Cantlie, Neil. A History of the Army Medical
Department. 2 vols. Edinburgh: Churchill
Livingstone, 1974.

Carney, Sydney H., Jr. “Some Medical Men in
the Revolution.” Magazine of History 21
(1915): 183-96.

Carrington, Henry B. Battles of the American
Revolution, 1775-1781: Historical and Mili-
tary Criticism With Topographical Illustra-
tion. 6th ed., rev. New York: A. S. Barnes
& Co., 1968.

Carson, Joseph. A History of the Medical De-
partment of the University of Pennsylvania,
From Its Foundation in 1765. Philadelphia:
Lindsay and Blakiston, 1869.

Casey, Powell A. Louisiana in the War of
1812. 1963.

Cash, Philip. Medical Men at the Siege of
Boston, April, 1775-April, 1776: Problems
of the Massachusetts and Continental
Armies. Philadelphia: American Philosophi-
cal Society, 1973.

Chard, Thornton. “Excerpts From the Private
Journal of Doctor John Cochran.” New
York History 42 (1944): 360-78.

. “Illustrations Pertaining to the Medical
Life of Doctor John Cochran.” Bulletin of
the History of Medicine 20 (1946): 76-84.

Claiborne, Nathaniel. Notes on the War in the
South. New York: Arno Press & The New
York Times, 1971 reprint of 1819 edition.

Claiborne, W. C. C. Official Letter Books of
W. C. C. Claiborne, 1801-1816. Edited by
Dunbar Rowland. 6 vols. Jackson, Miss.:
State Department of Archives and History,
1917.

Clark, William. “William Clark’s Journal of
General Wayne's Campaign.” Mississippi
Valley Historical Review 1 (1914-15): 418-
43.

 

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Clendening, Logan, ed. Source Book of Med-
ical History. New York: Dover Publica-
tions, 1942.

Clift, Garrett Glenn. Remember the Raisin:
Kentucky and Kentuckians in the Battles
and Massacre at Frenchtown, Michigan Ter-
ritory, in the War of 1812. Frankfort: Ken-
tucky Historical Society, 1961.

Closen, Ludwig von. The Revolutionary
Journal of Baron Ludwig von Closen, 1780-
1783. Edited by Evelyn M. Acomb. Chapel
Hill: University of North Carolina Press,
1958.

Cochran, John. Five Letters to Barnabas Bin-
ney. Pennsylvania Magazine of History and
Biography 5 (1881): 229-31.

Cochran Letter Book. See under Morristown,
N.J.

Cochrane, John. “Medical Department of the
Revolutionary Army.” Magazine of Ameri-
can History 12 (1884): 241-60.

Codman, John. Arnold's Expedition to Quebec.
New York: Macmillan Co., 1902.

Coles, Harry L. The War of 1812. Chicago:
University of Chicago Press, 1965.

Colyar, A. S. Life and Times of Andrew Jack-
son, Soldier, Statesman, President. 2 vols.
Nashville, Tenn.: Marshall & Bruce Co.,
1904.

Commager, Henry Steele, and Morris, Rich-
ard B., eds. The Spirit of Seventy-Six: The
Story of the American Revolution As Told
by Participants. New York: Harper & Row,
1967.

Comrie, John D. History of Scottish Medicine.
2d ed. 2 vols. London: Bailliére, Tindall, &
Cox, 1932.

Cook, Frederick, ed. Journals of the Military
Expedition of Major General John Sullivan
Against the Six Nations of Indians in 1779
With Records of Centennial Celebrations.
Auburn, N.Y.: Knapp, Peck & Thompson,
1887.

Cooke, John Henry. A Narrative of Events in
the South of France and of the Attack on
New Orleans, in 1814 and 1815. London:
T. & W. Boone, 1835.

Corbin, Henry C., and Thian, Raphael P.,
eds. Legislative History of the General Staff
of the Army of the United States. Wash-
ington: Government Printing Office, 1901.

Corner, Betsy Copping. William Shippen, Jr.:
Bibliography

Pioneer in American Medical Education.
Philadelphia: American Philosophical So-
ciety, 1951.

Corner, George W., ed. The Autobiography of
Benjamin Rush: His “Travels Through Life”
Together With His “Commonplace Book”
for 1789-1813. Princeton, N.J.: Princeton
University Press, 1948.

Craik, James. “A Letter Written by Jas. Craik
to Andrew Craigie, Esq., Apy. Genl., August
1780, Relating to the Condition of the
Army, Communicated by Nathaniel Paine.”
Massachusetts Historical Society Proceed-
ings, 2d ser. 15 (1901-2): 362-64.

Cross, Trueman. Military Laws of the United
States; to Which Is Prefixed the Constitu-
tion of the United States. Washington: Ed-
ward de Krafft, 1825.

Cruikshank, Ernest A. The Battle of Lundy's
Lane. Welland, Ontario: Lundy's Lane His-
torical Society, 1893.

. Documentary History of the Cam-
paign Upon the Niagara Frontier. 4 vols.
Arno Press & The New York Times, 1971
reprint of 1896-1908 edition.

Cullum, G. W., ed. Campaigns of the War of
1812-15. New York: Miller, 1879.

Cutbush, Edward. Observations on the Means
of Preserving the Health of Soldiers and
Sailors; and on the Duties of the Medical
Departments of the Army and Navy: With
Remarks on Hospitals and Their Internal
Arrangements. Philadelphia: Fry and Kam-
merer, 1808.

Dalton, R. H. “A Glance at the American
Medical Profession Since the Beginning of
the Present Century.” Journal of the Ameri-
can Medical Association 21 (1893): 953-
5s.

Darnell, Elias. “A Journal Containing an
Accurate and Interesting Account of the
Hardships, Sufferings, Battles, Defeat, and
Captivity of Those Heroic Kentucky Vol-
unteers and Regulars, Commanded by Gen-
eral Winchester, in the Years 1812-
1813 ....” Magazine of History, Extra No.
31. New York: W. Abbatt, 1914 reprint of
1854 edition.

David, Ebenezer. A Rhode Island Chaplain in
the Revolution, Letters of Ebenezer David
to Nicholas Brown, 1775-1778. Edited by
Jeannette D. Black and William Greene

 

273

Roelker. Providence: The Rhode Island So-
ciety of the Cincinnati, 1949.

Davidson, Chalmers Gaston. Friend of the
People: The Life of Peter Fayssoux of
Charleston. Columbia, S.C.: South Carolina
Medical Association, 1950.

Davis, John. “The Yorktown Campaign:
Journal of Captain John Davis, of the
Pennsylvania Line.” Pennsylvania Magazine
of History and Biography 5 (1881): 290-
310.

Davis, Nathan Smith. Contributions to the
History of Medical Education and Medical
Institutions in the United States of America,
1776-1876. Washington: Government Print-
ing Office, 1877.

. History of Medical Education and
Institutions in the United States From the
First Settlement of the British Colonies to
the Year 1850. Chicago: S. C. Griggs &
Co., 1851.

Dawson, Henry Barton. Battles of the United
States. 2 vols. New York: Johnson, Fry and
Co., 1858.

Dearborn, Henry. Journals of Henry Dearborn,
1776-1783. Cambridge: John Wilson and
Son, 1887.

De Grummond, Jane Lucas. The Baratarians
and the Battles of New Orleans. Baton
Rouge: Louisiana State University Press,
1961.

D’Elia, D. J. “Dr. Benjamin Rush and the
American Medical Revolution.” Proceedings
of the American Philosophical Society 110
(1966): 227-34.

Denny, Ebenezer. Military Journal of Major
Ebenezer Denny, An Officer in the Revolu-
tionary and Indian Wars, With the Intro-
ductory Memoir. Philadelphia: Historical
Society of Pennsylvania, 1859.

Devoto, Bernard, ed. The Journals of Lewis
and Clark. Boston: Houghton Mifflin Co.,
1953.

Diller, Theodore. Franklin’s Contribution to
Medicine. Brooklyn, N.Y.: Albert T. Hunt-
ington, 1912.

“Diseases of the Army of the Third United
States Military District.” Medical Reposi-
tory, new ser. 3 (1817): 407.

Dorland’s Illustrated Medical Dictionary. 24th
ed. Philadelphia: W. B. Saunders Co., 1965.

Draper, Lyman C. King’s Mountain and Its

 
274

Heroes: History of the Battle of King’s
Mountain, October 7th, 1780, and the
Events Which Led to It. Cincinnati: P. G.
Thomson, 1881.

Drinker, Cecil Kent. Not So Long Ago. New
York: Oxford University Press, 1937.

Drowne, Solomon. “Original Letters.” Penn-
sylvania Magazine of History and Biography
5 (1881): 110-14.

Dudley, Thomas P. “Battle and Massacre at
Frenchtown, Michigan, January 1813, by
Rev. Thomas P. Dudley, One of the Sur-
vivors.” Western Reserve and Northern
Ohio Historical Society Publications No. 1
(1870).

Duffy, John. Epidemics in Colonial America.
Baton Rouge: Louisiana State University
Press, 1953.

Duncan, Louis C. Medical Men in the Ameri-
can Revolution, 1775-1783. Army Medical
Bulletin No. 25. Carlisle Barracks, Pa.:
Medical Field Service School, 1931.

Durfee, David A., ed. William Henry Harri-
son 1773-1841; John Tyler 1790-1862;
Chronology — Documents — Bibliographic-
al Aids. Dobbs Ferry, N.Y.: Oceana Publi-
cations, 1970.

Eaton, Leonard K. “Military Surgery in the
Battle of Tippecanoe.” Bulletin of the His-
tory of Medicine 25 (1951): 460-63.

Efner, Elijah D. “The Adventures and Enter-
prises of Elijah D. Efner.” Publications of
the Buffalo Historical Society 4 (1896):
35-54.

Eliot, Ephraim. “Account of the Physicians of
Boston.” Proceedings of the Massachusetts
Historical Society 6 (1863-64): 177-84.

Elliott, Charles Winslow. Winfield Scott. New
York: Macmillan Co., 1937.

Eustis Papers. See under Washington, D.C.,
Library of Congress, Manuscript Division.

Ewell, James. The Medical Companion: Treat-
ing, According to the Most Successful Prac-
tice, I. The Diseases Common to Warm
Climates and on Ship Board; II. Common
Cases in Surgery, as Fractures, Dislocations
&c.; Ill. The Complaints Peculiar to Women
and Children, With a Dispensatory and
Glossary . . . . 3d ed. Philadelphia: privately
printed, 1817.

Fairchild, G. M., Jr., ed. Journal of an Ameri-
can Prisoner at Fort Malden and Quebec

THE ARMY MEDICAL DEPARTMENT,

1775-18138

in the War of 1812. Quebec:
printed, 1909.

Farmer, Laurence. “The Early Directors of
the Medical Services of the American Revo-
lutionary Army.” Bulletin of the New York
Academy of Medicine 36 (1960): 765-76.

Fay, Herman Allen. Collection of the Official
Accounts, in Detail, of All the Battles
Fought by Sea and Land Between the
Navy and Army of the United States and
the Navy and Army of Great Britain During
the Years 1812, 13, 14, & 15. New York,
1817.

Feltman, William. “The Journal of Lieut. Wil-
liam Feltman, of the First Pennsylvania
Regiment, From May 26, 1781, to April
25, 1782, Embracing the Siege of Yorktown
and the Southern Campaign.” Pennsylvania
Historical Society Collections 1 (1853):
303-48.

Fisher, Elijah. “Elijah Fisher's Journal While
in the War for Independence and Contin-
ued for Two Years After He Came to
Maine, 1775-1784." Magazine of History,
Extra No. 6.

Fitz, Reginald H. “Zabdiel Boylston, Inocu-
lator, and the Epidemic of Smallpox in
Boston in 1721.” Bulletin of the Johns Hop-
kins Hospital 22 (1911): 315-27.

Fitzpatrick, John C. The Spirit of the Revolu-
tion. Boston: Houghton Mifflin Co., 1924.

Fitzpatrick, John C., ed. The Diaries of George
Washington, 1748-1799. 4 vols. Boston:
Houghton Mifflin Co., 1925.

. The Writings of George Washington
From the Original Manuscript Sources,
1745-1799. 39 vols. Washington: Govern-
ment Printing Office, 1931-44.

Force, Peter, ed. American Archives: Fourth
and Fifth Series, Containing a Documentary
History of the United States of America
From March 7, 1774 to the Definitive
Treaty of Peace With Great Britain, Sep-
tember 3, 1783. 9 vols. Washington: M.
St. Clair Clarke and Peter Force, 1848-53.

Ford, Worthington Chauncey, ed. General
Orders Issued by Major-General Israel Put-
nam When in Command of the Highlands
in the Summer and Fall of 1777. Boston:
Gregg Press, 1972 reprint of 1893 edition.

Ford, Worthington Chauncey; Hunt, Gaillard;
and others, eds. Journals of the Continental

privately

 
Bibliography

Congress. 34 vols. Washington: Government
Printing Office, 1904-37.

Forman, Jonathan, comp. Physicians and the
Indian Wars. Columbus: Ohio State Medical
Association, 1953.

Fortier, Alcée. A History of Louisiana. 4
vols. New York: Manzi, Joyant & Co.,
1904.

Foster Papers. See under Washington, D.C.,
Library of Congress, Manuscript Division.

Fox, Cyrus T., ed. Reading and Berks County
Pennsylvania, A History. 3 vols. New York:
Lewis Historical Publishing Co., 1925.

Fox, Richard Hingston. Dr. John Fothergill
and His Friends, Chapters in Eighteenth
Century Life. London: Macmillan and Co.,
1919.

Freeman, Douglas Southall. Victory With the
Help of France. George Washington, A
Biography, vol. 5. New York: Charles
Scribner’s Sons, 1952.

French, Allen. General Gage’s Informers. Ann
Arbor: University of Michigan Press, 1932.

Friedman, Reuben. “Scabies in Colonial Amer-
ica.” Annals of Medical History, 3d ser.
2 (1940): 401-3.

Gahn, Bessie W. Brown. “Dr. William Brown,
Physician-General to the American Army.”
Journal of the American Pharmaceutical
Association 16 (1927): 1090-91.

Galdston, Iago. “The Rise of Modern Re-
search.” Ciba Symposia 8 (1946): 354-61.

Gale, Benjamin. “Historical Memoirs, Relating
to the Practice of Inoculation for the Small
Pox, in the British American Provinces,
Particularly in New England.” Philosophical
Transactions of the Royal Society of London
55 (1765): 193-204.

Ganoe, William Addleman. The History of
the United States Army. New York: D. Ap-
pleton and Co., 1924.

Gardner, Asa B. “The New York Continental
Line.” Magazine of American History 1
(1881): 401-19.

Garrison, Fielding H. History of Medicine.
Philadelphia: W. B. Saunders Co., 1914.

. “Notes on the History of Military
Medicine.” Military Surgeon 49-51 (1921-
22), reprinted by the Association of Military
Surgeons, 1922.

Gates, Horatio. “Letters of General Gates on

 

275

the Southern Campaign.” Magazine of
American History 5 (1880): 281-310.

General Committee of Defense. Observations
Relative to the Means of Preserving Health
in Armies. 7 September 1814.

Gibbes, R. W., ed. Reminiscences, Documen-
tary History of the American Revolu-
tion . . .. 3 vols. New York: D. Appleton
& Co., 1853-57.

Gibson, James E. “Captured Medical Men
and Army Hospitals of the American Revo-
lution.” Annals of Medical History, new
ser. 10 (1938): 382-89.

. Dr. Bodo Otto and the Medical

Background of the American Revolution.

Baltimore: Charles C Thomas, 1937.

. “John Augustus Otto.” Historical Re-

view of Berks County 13 (1947): 14-18.

. “The Role of Disease in the 70,000

Casualties in the American Revolutionary

Army.” Transactions and Studies of the

College of Physicians of Philadelphia, 4th

ser. 17 (1949): 121-27.

. “Smallpox and the American Revolu-
tion.” Genealogical Magazine and Histori-
ographical Chronicle 51 (1948): 55-57.

Gilman, C. M. B. “Military Surgery in the
American Revolution.” Journal of the Med-
ical Society of New Jersey 57 (1960):
491-96.

Godfrey, Carlos E. Organization of the Pro-
visional Army of the United States in the
Anticipated War With France, 1789-1800.
Pennsylvania Magazine of History and Biog-
raphy 38 (1914): 129-82.

Gooch, Benjamin. 4 Practical Treatise on
Wounds and Other Chirurgical Subjects; to
Which is Prefixed a Short Historical Ac-
count of the Rise and Progress of Surgery
and Anatomy, Addressed to Young Sur-
geons. 2 vols. Norwich: W. Chase, 1767.

Goodman, Nathan G. Benjamin Rush, Physi-
cian and Citizen, 1746-1813. Philadelphia:
University of Pennsylvania Press, 1934.

Gordon, Maurice B. Aesculapius Comes to the
Colonies. Ventnor, N.J.: Ventnor Publishers,
1949.

. “Medicine in Colonial New Jersey
and Adjacent Areas.” Bulletin of the His-
tory of Medicine 17 (1945): 38-60.

Gore, Albert A. The Story of Our Services
Under the Crown: A Historical Sketch of

 

 

 

 

 
276

the Army Medical Staff. London: Bailliere,
Tindall, & Cox, 1879.

Graham, Harvey. The Story of Surgery.
Garden City, N.Y.: Doubleday, Doran &
Co., 1939.

Graham, Joseph. “Narrative of the Revolu-
tionary War in North Carolina in 1780
and 1781.” In Papers of Archibald D.
Murphey. Edited by W. H. Hoyt. 3 vols.
Raleigh, 1914.

Graves, Charles B. “Dr. Philip Turner of
Norwich, Connecticut.” Annals of Medical
History 10 (1928): 1-24.

Green, Constance McLaughlin. Washington,
Village and Capital, 1800-1878. Princeton,
N.J.: Princeton University Press, 1962.

Greene, George Washington. The Life of Na-
thanael Greene. 3 vols. New York: G. P.
Putnam and Son, 1867-1871.

Greene, Nathanael. “Report on the ‘Battle of
Eutaw Springs.”” Magazine of History,
Extra No. 3.

Greenhous, Brereton. “A Note on Western
Logistics in the War of 1812.” Military Af-
fairs 34 (1970): 41-44.

Gregorie, Anne King. Thomas Sumter. Colum-
bia, $.C.: BR. 1. Bryan Co., 1931.

Griffenhagen, George B. Drug Supplies in the
American Revolution. U.S. National Muse-
um Bulletin 225. Washington: Smithsonian
Institution, 1961.

Hadel, Albert Kimberley. ‘The Battle of
Bladensburg.” Maryland Historical Maga-
zine 1 (1906): 155-67.

Hales, Stephen. A Treatise on Ventilators.
London: Manby, 1758.

Hall, Courtney Robert. “The Beginnings of
American Military Medicine.” Annals of
Medical History, 3d ser. 4 (1942): 122-31.

Hamersly, Thomas H. S. Complete Army and
Navy Register of the United States of Amer-
ica, From 1776 to 1887. New York: T. H.
S. Hamersly, 1888.

Hamilton, John Taylor. 4 History of the
Church Known as the Moravian Church,
or the Unitas Fratrum or the Unity of the
Brethren During the Eighteenth and Nine-
teenth Centuries. Transactions of the Mora-
vian Historical Society, vol. 6. Bethlehem,
Pa.; Times Publishing Co., 1900.

Hamilton, Kenneth Gardiner. John Ettwein
and the Moravian Church During the Revo-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

lutionary Period. Bethlehem, Pa.: Times
Publishing Co., 1940.

Hamilton, Robert. Observations on the Marsh
Remittent Fever . . . . London: T. Gillet,
1801.

Hand, Edward. “Orderly Book of General
Edward Hand, Valley Forge, January
1778.” Pennsylvania Magazine of History
and Biography 41 (1917): 198-223, 257-
73, 458-68.

Harmar, Josiah. The Proceedings of a Court
of Inquiry, Held at the Special Request of
Brigadier General Josiah Harman . . . .
Philadelphia, 1791.

Harris, David. “Medicine in Colonial Ameri-
ca.” California and Western Medicine 50
(1939): 355-58, 415-18; 51 (1939):
35-38.

Harrison, William Henry. Governors’ Mes-
sages and Letters, Messages & Letters of
William Henry Harrison. Edited by Logan
Esarey. 4 vols. Indianapolis: Indiana His-
torical Commission, 1922.

Harvey, Samuel Clark. The History of Hemo-
stasis. New York: Paul B. Hoeber, 1929.

Hatch, Louis Clinton. The Administration of
the American Revolutionary Army. Harvard
Historical Studies, vol. 10. New York:
Lenox Hill, 1904.

Hatch, William Stanley. A Chapter of the His-
tory of the War of 1812 in the Northwest.
Embracing the Surrender of the North-
western Army and Fort, at Detroit, August
16 1812. With a Description and Biographi-
cal Sketch of the Celebrated Indian Chief
Tecumseh. Cincinnati: Miami Printing and
Publishing Co., 1872.

Hawke, David Freeman. Benjamin Rush: Rev-
olutionary Gadfly. Indianapolis: Bobbs-
Merrill, 1971.

Heart, Jonathan. Journal of Capt. Jonathan

Heart . . . . Edited by Consul Willshire
Butterfield. Albany, N.Y.: Joel Munsell’s
Sons, 1885

Heath, William. Heath’s Memoirs of the Ameri-
can War. Edited by Rufus Rockwell Wilson.
New York: A. Wessels Co., 1904.

Heaton, Claude Edwin. “Medicine in New
York During the English Colonial Period,
1664-1775.” Bulletin of the History of
Medicine 17 (1945): 9-37.
Bibliography

Heckwelder, John. “Narrative of His Journey
to the Wabash in 1792.” Pennsylvania Maga-
zine of History and Biography 11 (1887):
466-75; 12 (1888): 34-54.

Heiges, George L. “Letters Relating to Colonial
Military Hospitals in Lancaster County.”
Lancaster County (Pa.) Historical Society
Papers 52 (1948): 73-96.

Heitman, Francis Bernard. Historical Register
and Dictionary of the United States Army
From Its Organization, September 29, 1789,
to March 2, 1903. 2 vols. Washington:
Government Printing Office, 1903. ,

. Historical Register of Officers of the
Continental Army During the War of the
Revolution, April 1775 to December 1783.
Washington, 1892-93.

Hess, Alfred. Scurvy, Past and Present. Phila-
delphia: J. B. Lippincott, 1920.

Heustis, Jabez W. “Observations on the Disease
Which Prevailed in the Army at Camp Ter-
reaux-Boeufs, in June, July, and August of
the Year 1809.” Medical Repository, 2d
ser. 3 (1817): 33-41.

. Physical Observations, and Medical
Tracts and Researches on the Topography
and Diseases of Louisiana. New York: T.
and J. Swords, 1817.

Higginbotham, Don. The War of American
Independence, Military Attitudes, Policies,
and Practice, 1763-1789. New York: Mac-
millan Co., 1971.

Hindle, Brooke. The Pursuit of Science in
Revolutionary America, 1735-1789. Chapel
Hill: University of North Carolina Press,
1956.

Hocker, Edward W. “Medical Men Deserve
Tribute for Care of Washington's Men at
Valley Forge Encampment.” Picket Post 16
(1947): 7-14.

Horner, W. E. “Surgical Sketches.” Medical
Examiner and Record of Medical Science,
new ser. 8 (1852): 753-74; 9 (1852): 1-24,
69-85.

Hosack, David. 4 Biographical Memoir of
Hugh Williamson, M.D., LL.D. New York:
C. S. Van Winkle, 1820.

. Observations on the Laws Governing

the Communication of Contagious Diseases

and the Means of Arresting Their Progress.

New York: Van Winkle and Wiley, 1815.

 

 

 

271

Howe, Eber D. “Recollections of a Pioneer
Printer.” Buffalo Historical Society Publica-
tions 9 (1906): 375-406.

Hull, William. Memoirs of the Campaign of the
Northwestern Army of the United States,
1812. Boston: True & Greene, 1824.

Hume, Edgar Erskine. Victories of Army
Medicine: Scientific Accomplishments of the
Medical Department of the United States
Army. Philadelphia: J. B. Lippincott Co.,
1943.

Hunter, John. Hunterian Reminiscences; Being
the Substance of a Course of Lectures on
the Principles and Practice of Surgery, De-
livered by the Late Mr. John Hunter, in the
Year 1785. Edited by J. W. K. Parkinson.
London: Sherwood, Gilbert, and Pepir,
1833.

. Observations on the Diseases of the

Army in Jamaica and on the Best Means of

Preserving the Health of Europeans in the

Climate. Also, Observations on the Hepatitis

of the East Indies. 3d ed. London: T. Payne,

1808.

. Treatise on the Blood, Inflammation

and Gunshot Wounds. London: John Rich-

ardson, 1794.

. A Treatise on the Venereal Disease.
Abridged by William Currie. Philadelphia:
Charles Cist, 1787.

Huntt, Henry. “An Abstract Account of the
Diseases Which Prevailed Among the
Soldiers, Received into the General Hospital,
at Burlington, Vermont, During the Summer
and Autumn of 1814.” Medical Recorder 1
(1818): 176-79.

Hutchinson, James. “Notes: Valley Forge.”
Pennsylvania Magazine of History and
Biography 39 (1915): 221.

Ingersoll, Lurton Dunham. A History of the
War Department of the United States, With
Biographical Sketches of the Secretaries.
Washington: Francis D. Mohun, 1880.

Izard, George. Official Correspondence With
the Department of War Relative to the
Military Operations of the American Army
Under the Command of Major General Izard
on the Northern Frontier of the United
States in the Years 1814 and 1815. Phila-
delphia: Thomas Dobson, 1816.

Jackson, Robert. 4 System of Arrangement

 

 

 
278

and Discipline for the Medical Department
of Armies. London: John Murray, 1805.

Jacobs, James Ripley. The Beginning of the
US. Army, 1783-1812. Port Washington,
N.Y.: Kennikat Press, 1947, reissued 1970.

. Tarnished Warrior, Major-General
James Wilkinson. New York: Macmillan
Co., 1938.

Jacobs, James Ripley, and Tucker, Glenn. The
War of 1812: A Compact History. New
York: Hawthorn Books, 1969.

James, Marquis. Andrew Jackson: The Border
Captain. Indianapolis: Bobbs-Merrill, 1933.

Jay, William. “Table of the Killed and Wound-
ed in the War of 1812: Compiled During the
War.” Collections of the New York His-
torical Society, 2d ser. 7 (1849): 447-66.

Johnson, Victor Leroy. The Administration of
the American Commissariat During the
Revolutionary War. Philadelphia, 1941.

. “Robert Morris and the Provisioning
of the American Army During the Campaign
of 1781.” Pennsylvania History 5 (1938):
7-20.

Jones, Edward Alfred. The Loyalists of Massa-
chusetts: Their Memorials, Petitions and
Claims. Baltimore: Genealogical Publ. Co.,
1969.

Jones, John. The Surgical Works of the Late
John Jones, M.D. 3d ed. Edited by James
Mease. Philadelphia: Wrigley and Berriman,
1795.

Jones, Joseph. Letters of Joseph Jones of Vir-
ginia, 1777-1787. Edited by Worthington
Chauncey Ford. New York: New York
Times, 1971 reprint of 1889 edition.

Jordan, John W. “Continental Hospital Re-
turns.” Pennsylvania Magazine of History
and Biography 23 (1899): 35-50, 210-33.

. “The Military Hospitals at Bethlehem
and Lititz During the Revolution.” Pennsyl-
vania Magazine of History and Biography 20
(1896): 137-57.

Joy, Col Robert J. T., to author, letters, 25
March 1976 and 11 June 1976.

Kebler, Lyman F. “Andrew Craigie, the First
Apothecary General of the United States.”
Journal of the American Pharmaceutical
Association 17 (1928): 63-74, 167-78.

Kendig, John D. 4 Legendary and Factual
Review of the Times of Henry William

 

 

 

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Steigel and the Early Days of Manheim.
n.p., 1957.

King, L. S. The Medical World of the Eight-
eenth Century. Chicago: University of Chi-
cago Press, 1958.

Kinzie, John. “Narrative of the Ft. Dearborn
Massacre.” Edited by Mentor L. Williams.
Illinois State Historical Society Collections
46 (1953): 343-62.

Kirkwood, Robert. The Journals and Order
Book of Captain Robert Kirkwood of the
Delaware Regiment of the Continental Line.
Edited by Joseph Brown Turner. Port Wash-
ington, N.Y.: Kennikat Press, 1910.

Klebs, Arnold C. “The Historic Evolution of
Variolation.” Bulletin of Johns Hopkins
Hospital 24 (1913): 69-83.

Knollenberg, Bernard, ed. “The Correspond-
ence of John Adams and Horatio Gates.”
Proceedings of the Massachusetts Historical
Society 67 (1941-44): 135-51.

Knopf, Richard C., ed. Campaign Into the
Wilderness: The Wayne-Knox-Pickering-
McHenry Correspondence. 5 vols. Colum-
bus, Ohio: Anthony Wayne Parkway Board,
1955.

. Document Transcriptions of the War

of 1812 in the Northwest. 8 vols. Colum-

bus, Ohio: Anthony Wayne Parkway Board.

1957-62.

. “A Surgeon’s Mate at Fort Defiance:

The Journal of Joseph Gardner Andrews for

the Year 1795.” Ohio Historical Quarterly

66 (1957): 57-86, 159-86, 238-68.

. “Two Journals of the Kentucky Vol-
unteers, 1793 and 1794.” Filson Club His-
torical Quarterly 27 (1953): 247-81.

Kraus, Michael. “American and European
Medicine in the Eighteenth Century.” Bulle-
tin of the History of Medicine 8 (1940):
679-95.

Kreidberg, Marvin A., and Henry, Merton G.
History of Military Mobilization in the
United States Army 1775-1945. Department
of the Army Pamphlet 20-212, June 1955.

Kremers, E., and Urdang, G. History of
Pharmacy. 2d ed. Philadelphia: J. B. Lippin-
cott Co., 1951.

Ladenheim, Jules Calvin. “The Doctors’ Mob
of 1788.” Journal of the History of Medicine
and Allied Sciences 5 (1950): 23-43.

 

 

 
Bibliography

Lafayette, Marie Joseph Paul Yves. Mémoires,
correspondance, et manuscrits du général
Lafayette publiées par sa famille. 2 vols.
Brussels: Société belge de Librairie, 1837.

Lane, John E. “Jean-Frangois Coste, Chief
Physician of the French Expeditionary
Forces in the American Revolution.” 4meri-
cana 22 (1928): 51-80.

Latour, Arséne Lacarriére. Historical Memoir
of the War in West Florida and Louisiana in
1814-15. Gainesville: University of Florida
Press, 1964 reprint of 1816 edition.

Laurens, John. The Army Correspondence of
Colonel John Laurens in the Year 1777-8,
Now First Printed From Original Letters
Addressed to His Father, Henry Laurens,
President of Congress, With a Memoir by
William Gilmore Simms. New York: The
Bradford Club, 1867.

Le Dran, Henri Frangois. The Operations in
Surgery of Mons. Le Dran. Translated by
Thomas Gataker. London: C. Hitch and R.
Dodsby, 1749.

Lee, Henry. Memoirs of the War in the South-
ern Department of the United States. 2 vols.
Philadelphia: Bradford and Inskeep, 1812.

Lee, Richard H. Memoir of the Life of Richard
Henry Lee and His Correspondence With
the Most Distinguished Men in America and
Europe. lllustrations of Their Characters and
of the Events of the American Revolution.
2 vols. Philadelphia: H. C. Carey and IL
Lea, 1825.

Leikind, Morris C. “Vaccination in Europe.”
Ciba Symposia 3 (1942): 1102-13, 1124.
Lesser, Charles H., ed. The Sinews of Inde-
pendence: Monthly Strength Reports of the
Continental Army. Chicago: University of

Chicago Press, 1976.

Levering, Joseph Mortimer. A History of Beth-
lehem, Pennsylvania, 1741-1892, With Some
Account of Its Founders and Their Early
Activity in America. Bethlehem, Pa.: Times
Publishing Co., 1903.

Lewis, Fraser. “Medicine in the Continental
Army of the Revolutionary War: 1775-
1783.” Philadelphia Medicine 55 (1959):
254-55, 257-59.

Lind, James. An Essay on Diseases Incidental
in Europeans in Hot Climates With the
Method of Preventing Their Fatal Conse-

279

quences. London: T. Becket & P. A. De

Hondt, 1768.

. A Treatise of the Scurvy: In Three
Parts. Containing an Inquiry Into the Nature,
Causes, and Cure of That Disease; Together
With a Critical and Chronological View of
What Has Been Published on the Subject.
Edinburgh: Sands, Murray, and Cochran for
A. Kincaid & A. Donaldson, 1753.

Lucia, Salvatore P. 4 History of Wine as
Therapy. Philadelphia: J. B. Lippincott Co.,
1963.

Mahon, John K. The War of 1812. Gainesville:
University of Florida Press, 1972.

Major, R. H. 4 History of Medicine. Spring-
field, Ill.: Charles C Thomas, 1954.

Mann, James. Medical Sketches of the Cam-
paigns of 1812, 13, 14 . . . . Dedham, Mass.:
H. Mann and Co., 1816.

Marine, William M. The British Invasion of
Maryland, 1812-1815. Baltimore: Society of
the War of 1812 in Maryland, 1913.

Martin, C. H. “The Military Hospital at the
Cloister (Ephrata, Pa., 1777).” Lancaster
County (Pa.) Historical Society Papers 51
(1947): 127-33.

Martin, John Hill. Historical Sketch of Bethle-
hem in Pennsylvania. New York: AMS
Press, 1971 reprint of 1872 edition.

Massachusetts (Colony) Provincial Congress.
The Journals of the Provincial Congress of
the Massachusetts Bay Colony in 1774 and
1775 and of the Committee of Safety . . . .
Boston: Dutton and Wentworth, 1838.

Matloff, Maurice, ed. American Military His-
tory. Washington: Government Printing
Office, 1969.

McCarty, William. History of the American
War of 1812, From the Commencement, Un-
til the Final Termination Thereof, on the
Memorable Eighth of January, 1815, at
New Orleans. 2d ed. Freeport, N.Y.: Books
for Libraries Press, 1970 reprint of 1816
edition.

McCulloch, Champe C. “The Scientific and
Administrative Achievement of the Medical
Corps of the United States Army.” Scientific
Monthly 1 (1917): 410-27.

McDowell, William. “Journal of Lieut William
McDowell of the First Penna Regiment, in
the Southern Campaign 1781-1782.” Penn-
sylvania Archives, 2d ser. 15: 296-340.

 
280

McGrady, Edward. The History of South Caro-
lina in the Revolution 1780-1783. 2 vols.
New York: Russell & Russell, 1969 reissue
of 1902 edition.

McKee, Marguerite. “Service of Supply in the
War of 1812.” Quartermaster Review 6
(1927): 45-55.

Medical Department, U.S. Army. Com-
municable Diseases. Preventive Medicine in
World War II, vol. 6. Washington: Govern-
ment Printing Office, 1963.

. Infectious Diseases. Internal Medicine
in World War II, vol. 2. Washington: Gov-
ernment Printing Office, 1963.

“Medical History of Louis XIV (Editorial).”
Annals of Medical History, 1st ser. 8
(1926): 202-3.

Mendham, New Jersey, Mayor's Tercentenary
Committee. The Mendhams. Brookside, N.J.,
1964.

Middleton, Peter. A Medical Discourse, or an
Historical Inquiry Into the Ancient and
Present State of Medicine; the Substance of
Which Was Delivered at Opening the Medi-
cal School, in the City of New York. New
York: Hugh Gaine, 1769.

Middleton, William Shainline. “John Morgan,
Father of Medical Education in North
America.” Annals of Medical History, 1st
ser. 9 (1927): 13-26.

. “Medicine at Valley Forge.” Annals

of Medical History, 3d ser. 3 (1941): 461-

86.

 

 

 

. “William Shippen, Junior.” Annals of
Medical History, n. s. 4 (1932): 442-52,
538-49.

Miller, Genevieve. “Medical Schools in the
Colonies.” Ciba Symposia 8 (1947): 522-
32.

Miller, Samuel. A Brief Retrospect of the
Eighteenth Century. 2 vols. New York: T.
and J. Swords, 1803.

Mitchell, Silas Weir. The Early History of
Instrumental Precision in Medicine. New
Haven: Tuttle, Morehouse & Taylor, 1892.

Mockridge, Ella W. Our Mendham. Ann
Arbor, Mich., 1961.

Monro, Donald. An Account of the Diseases
Which Were Most Frequent in the British
Military Hospitals in Germany, From Jan-
uary 1761 to the Return of the Troops to
England in March 1763 . . . . London: A.

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Millar, D. Wilson, T. Durham, and T.
Payne, 1764.

Montross, Lynn. Rag, Tag and Bobtail: The
Story of the Continental Army, 1775-1783.
New York: Harper & Bros., 1952.

“Monument at Ephrata to Brandywine Battle
Victims.” Magazine of American History 30
(1902): 75.

Moré, Charles Albert, Chevalier de Pontgibaud.
A French Volunteer of the War of Inde-
pendence. Translated and edited by Robert
B. Douglas. New York: Benjamin Bloom,
1972.

Morgan, John. “A Discourse Upon the Insti-
tution of Medical Schools in America.” In
Publications of the Institute of the History
of Medicine. Johns Hopkins University, ser.
4, Bibliotheca Medica Americana, vol. 2.
Reprinted facsimile from the first edition
(Philadelphia: William Bradford, 1765)
with introduction by Abraham Flexner.
Baltimore: Johns Hopkins Press, 1937.

. A Recommendation of Inoculation,

According to Baron Dimsdale’s Method.

Boston: J. Gill, 1776.

. A Vindication of His Public Charac-
ter in the Station of Director-General of the
Military Hospitals, and Physician in Chief
to the American Army, Anno 1776. Boston:
Powars and Willis, 1777.

Morris, Robert, to Thomas Bond, letters, 19
February 1782 and 19 June 1783, Xeroxes
held by Library of Congress, obtained from
Miss Elizabeth Thomson.

Morristown, N.J. Morristown National His-
torical Park. John Cochran Letter Book,
microfilm 5168.

Morton, Thomas George, and Woodbury,
Frank. History of the Pennsylvania Hospital
1751-1895. New York: Arno Press, 1973
reprint of 1895 edition.

Moultrie, William. Memoirs of the American
Revolution . . . . 2 vols. New York: New
York Times & Arno Press, 1968 reprint of
1802 edition.

Muhlenberg, J. P. “Orderly Book of Gen.
John Peter Gabriel Muhlenberg, March 26-
December 20, 1777.” Pennsylvania Maga-
zine of History and Biography 34 (1910):
21-40, 336-60, 438-77.

Multhauf, Robert P. A Catalogue of Instru-
ments and Models in the Possession of the

 

 
Bibliography

American Philosophical Society. Philadel-
phia: American Philosophical Society, 1961.

Mumford, James Gregory. 4 Narrative of
Medicine in America. Philadelphia: J. B.
Lippincott Co., 1903.

Munford, Robert B., Jr. “Military Hospital in
Williamsburg, 1777.” Virginia Magazine of
History 30 (1922): 388-90.

Murray, Louise Wells, ed. Notes From Craft
Collection in Tioga Point Museum on the
Sullivan Expedition of 1779 and Its Centen-
nial Celebration of 1879, Including Order
Book of General Sullivan Never Before
Published. Original Manuscript in the New
Jersey Historical Society. Athens, Pa., 1929.

Myer, Jesse S. Life of William Beaumont. St.
Louis: C. V. Mosby Co., 1939.

National Archives Record Groups. See under
Washington, D.C.

New York (State) University. Division of
Archives and History. The Sullivan-Clinton
Campaign in 1779. Chronology and Selected
Documents. Albany: University of the State
of New York, 1929.

Niles’ Weekly Register. Baltimore, Md.

North Carolina. The State Records of North
Carolina. 26 vols. Goldsboro, N.C.: Nash
Bros., 1886-1907.

Norwood, William Frederick. “The Enigma of
Dr. Benjamin Church, A High-Level Scandal
in the American Colonial Army Medical
Service.” Medical Arts and Sciences 10
(1956): 71-93.

Medical Education in the United

States Before the Civil War. Philadelphia:

University of Pennsylvania Press, 1944.

. “Medicine in the Era of the Ameri-
can Revolution.” International Record of
Medicine 171 (1958): 391-407.

“Order of March of Hand’s Brigade From
Wyoming to Tioga.” Pennsylvania Archives,
6th ser. 14: 67-121.

“Orderly Book, June 19 1779-July 30 1779.”
Pennsylvania Archives, 6th ser. 14: 21-65.

Original Papers Relating to the Siege of
Charleston, 1780, Mostly Selected From the
Papers of General Benjamin Lincoln, in the
Thomas Addis Emmet Collection, Lenox
Library, New York, and Now First Pub-
lished. Charleston, S.C.: Walker, Evans &
Cogwell Co., 1898.

 

 

 

281

Owen, William O. A Chronological Arrange-
ment of Congressional Legislation Relating
to the Medical Corps of the United States
Army From 1785 to 1917. Chicago: Ameri-
can Medical Association, 1918.

Owen, William O., ed. The Medical Depart-
ment of the United States Army (Legisla-
tive and Administrative History). During the
Period of the Revolution (1776-1786).
Compiled From the Journals of the Pro-
vincial Congress of Massachusetts Bay,
1775, and From the Journals of the Conti-
nental Congress, 1774-1783. New York:
Paul B. Hoeber, 1920.

Packard, Francis Randolph. “Editorial: Wash-
ington and the Medical Affairs of the Revo-
lution.” Annals of Medical History, ns. 4
(1932): 306-12.

. History of Medicine in the United

States. New York: Paul B. Hoeber, 1931.

. “How London and Edinburgh Influ-

enced Medicine in Philadelphia in the

Eighteenth Century.” Annals of Medical

History, n.s. 4 (1932): 227-28.

. Some Account of the Pennsylvania
Hospital, From Its First Rise to the Begin-
ning of the Year 1938. Philadelphia: Lea
& Febiger, 1938.

Palmer, Thomas H., ed. Historical Register of
the United States. 4 vols. Philadelphia,
1814-16.

Parish, John C., ed. The Robert Lucas Journal
of the War of 1812. Iowa City, Iowa: State
Historical Society of Iowa, 1906.

Parton, James. Life of Andrew Jackson. 3 vols.
Boston: Fields, Osgood & Co., 1870.

Peckham, Howard H., ed. The Toll of Inde-
pendence: Engagements & Battle Casualties
of the American Revolution. Chicago: Uni-
versity of Chicago Press, 1974.

Pennsylvania Infantry. 5th Regiment Orderly
Book of the Northern Army at Ticonderoga
and Mt. Independence From October 17th,
1776, to January 8th, 1777, With Biographi-
cal and Explanatory Notes and an Appen-
dix. Albany: J. Munsell, 1859.

Pennsylvania Packet. Philadelphia, Pa.

Pepper, O. H. Perry. “Benjamin Rush’s
Theories on Blood Letting After One Hun-
dred and Fifty Years.” Transactions of the
College of Physicians of Philadelphia, 4th
ser. 14 (1946): 121-26.

 

 
282

Pepper, William. The Medical Side of Benja-
min Franklin. Philadelphia: William J.
Campbell, 1911.

Peterson, Clarence Stewart. Known Military
Dead During the War of 1812. Baltimore,
1955.

Phalen, James M. Chiefs of the Medical De-
partment, United States Army, 1775-1940.
Army Medical Bulletin No. 52. Carlisle
Barracks, Pa.: Medical Field Service School,
April 1940.

. “Surgeon James Mann's Observations
on Battlefield Amputations.” Military Sur-
geon 87 (1940): 463-66.

Philadelphia, Pa. Historical Society of Penn-
sylvania. Manuscript Department. Alison
Papers, Continental Hospital Returns, 1777-
78.

 

 

. Autograph Collection, case 19, box

15, Papers of Thomas Bond, Jr.

. Journal of James Sproat, D.D., 1753,

1757, 1778, 1779, 1780, 1782, 1783, 1784,

1786.

. Papers of Jonathan Potts.

. Society Miscellaneous Collection, case
19, box 2.

Pilcher, James Evelyn. “Benjamin Church,
Director General and Chief Physician of
the Hospital of the Army, 1775.” Journal
of the Association of Military Surgeons
13 (1903): 320-24.

Postell, William Dosite. “Medical Education
and Medical Schools in Colonial America.”
International Record of Medicine 171
(1958): 364-70.

Potts Papers. See under Philadelphia, Pa.

Power, D'Arcy. Selected Writings: 1877-1930.
Oxford: Clarendon Press, 1931.

Pringle, John. Observations on the Diseases in
the Army, in Camp and Garrison. London:
A. Millar, D. Wilson, and T. Payne, 1752.

. Six Discourses, Delivered by Sir John
Pringle, Bart. . . ., To Which Is Prefixed
the Life of the Author by Andrew Kippis,
D.D.F.R.S. and S. A. London: W. Stra-
han and T. Cadell, 1783.

Prucha, Francis Paul. A Guide to the Military
Posts of the United States, 1789-1895.
Madison: State Historical Society of Wis-
consin, 1964.

Quaife, Milo Milton, ed. War on the Detroit,
the Chronicles of Thomas Verchéres de

 

 

 

 

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Boucherville and the Capitulation by an
Ohio Volunteer. Chicago: Lakeside Press,
1940.

Quincy, Eliza Susan Morton. “Basking Ridge
in Revolutionary Days. Reprinted From
Her Memoirs.” The Somerset County His-
torical Quarterly 1 (1912): 34-43.

. Memoirs. Boston: John Wilson and
Son, 1861.

Radbill, Samuel X. “Francis Alison Jr., a Sur-
geon of the Revolution.” Bulletin of the
Hi tory nf Medicine 9 (1941): 243-57.

Ramsay, David. The History of the Revolu-
tion in Soutn-Carolina . . . . 2 vols. Trenton:
Isaac Collins, 1785.

. A Review of the Improvements, Prog-
ress and State of Medicine in the XVIIIth
Century. Charleston: W. P. Young, 1801.

Ratcliffe, A. W. “The Historical Background
of Malaria—a Reconsideration.” Journal
of the Indiana Medical Association 39
(1946): 339-47.

Ravaton, Hugues. Chirurgie d'armée ou
traité des plaies d’armées a feu. Paris: Didot
le jeune, 1768.

Record Groups in National Archives. See
under Washington, D.C.

Reed, John Frederick. Campaign to Valley
Forge, July 1, 1777-December 19, 1777.
Philadelphia: University of Pennsylvania
Press, 1965.

Reed, William Bradford, ed. Life and Cor-
respondence of Joseph Reed. 2 vols. Phila-
delphia: Lindsay and Blakiston, 1847.

“Review of Circular Letter of Benjamin Water-
house to His Surgeons in the 2nd Military
District, September 1817.” Medical Reposi-
tory 19 (1818): 395-96.

RG (Record Group). See under Washington,
D.C., National Archives.

Risch, Erna. Quartermaster Support of the
Army: A History of the Corps, 1775-1939.
Washington: Government Printing Office,
1962.

Roberts, Kenneth Lewis, ed. March to Quebec:
Journals of the Members of Arnold's Expe-
dition. New York: Doubleday, Doran & Co.,
1938.

Rowland, Eron Opha. Andrew Jackson's Cam-
paign Against the British, or the Mississip-
pi Territory in the War of 1812 . . . .

 

 
Bibliography

Freeport, N.Y.: Books for Libraries Press,
1971 reprint of 1926 edition.

Rush, Benjamin. Observations on the Cause
and Cure of the Tetanus. Philadelphia,
1787.

Saffell, W. T. R. Records of the Revolutionary
War . . . . New York: Pudney & Russell,
1859.

Saffron, Morris H. Surgeon to Washington:
Dr. John Cochran (1730-1807). New York:
Columbia University Press, 1977.

St. Clair Papers. See under Washington, D.C.,
Library of Congress, Manuscript Division.
Sanders, Jennings Bryan. Evolution of Execu-
tive Departments of the Continental
Congress. Gloucester, Mass.: Peter Smith,

1971 reprint of 1935 edition.

Sanford, William. 4 Few Practical Remarks
on the Medicinal Effects of Wine and
Spirits. London: J. Tombs, 1799.

Sargent, Winthrop. “Winthrop Sargent’s Diary
While With General Arthur St. Clair’s Ex-
pedition Against the Indians.” Ohio Archae-
ological and Historical Quarterly 33 (1924):
237-73.

Schuyler, Philip John. “Proceedings of a Gen-
eral Court Martial . . . .” Collections of the
New York Historical Society for the Year
1879.

Scott, Winfield. Memoirs of Lieut.-General
Scott, LL.D. 2 vols. New York: Sheldon
& Co., 1864.

Senn, Nicholas. “The Evolution of the Military
Surgeon.” Surgery, Gynecology, & Ob-
stetrics 8 (1909): 393-400.

Sewall, Henry. “Letters.” Historical Magazine,
2d ser. 2 (1867): 608.

Seymour, William. “Journal of the Southern
Expedition, 1780-1783, by William Sey-
mour, Sergeant-Major of the Delaware Regi-
ment.” Pennsylvania Magazine of History
and Biography 7 (1883): 286-98, 377-94.

Shaw, John. “Narrative of John Shaw: Dic-
tated to Lyman C. Draper.” Wisconsin
State Historical Society Publications 2
(1855): 197-232.

Shippen, William. “Text of William Shippen’s
First Draft of a Plan for the Organization
of the Military Hospital During the Revolu-
tion.” Annals of Medical History 1 (1917-
18): 174-76.

Shippen, Just Account. See Philadelphia, Pa.,

283

Historical Society of Pennsylvania, Manu-
script Department, Society Miscellaneous
Collection.

Shreve, Lt Col Israel, to Mary Shreve, letter,
18 July 1776, Shreve copybook in the
family collection of Mr. and Mrs. Charles
J. Simpson, Potomac, Md.

Shryock, Richard Harrison. American Medi-
cal Research: Past and Present. New York:
Commonwealth Fund, 1947.

. The Development of Modern Medi-

cine: An Interpretation of the Social and

Scientific Factors Involved. New York: Al-

fred A. Knopf, 1947.

Eighteenth Century Medicine in

America. Worcester, Mass.: American An-

tiquarian Society, 1950.

. Medical Licensing in America, 1650-

1965. Baltimore: Johns Hopkins Press,

1967.

. “Medical Practice in the Old South.”

South Atlantic Quarterly 29 (1930): 160-

78.

 

 

 

 

 

. “The Medical Reputation of Benja-
min Rush: Contrasts Over Two Centuries.”
Bulletin of the History of Medicine 45
(1971): 507-52.

: . Medicine and Society in America,

1660-1860. Ithaca, N.Y.: Cornell Univer-

sity Press, 1960.

. “Public Relations of the Medical Pro-
fession in Great Britain and the United
States: 1600-1870.” Annals of Medical
History, n.s. 2 (1930): 308-39.

Shute, Daniel. “The Journal of Dr. Daniel
Shute, Surgeon in the Revolution 1781-
1782.” New England Genealogical Register
84 (1930): 383-89.

“Sickness in the Army at New Orleans, in
1809." Medical Repository 14 (1811):
85-87.

Sinipson, Stephen, to George Simpson, 9 Jan-
uary 1815. American Historical Review 2
(1896): 268.

Slocum, Charles E. “Some Errors Corrected:
Fort Winchester, at Defiance, Ohio.” Ohio
Archeological and Historical Quarterly 10
(1901-2): 483.

Smart, Charles. The Connection of the Army
Medical Department With the Develop-
ment of Meteorology in the United States.
U.S. Department of Agriculture, Weather

 

 
284

Bureau. Report of the International Meteo-

rological Congress Held at Chicago, III,

21-24 August 1893. Bulletin No. 11, 1895.

. “Medical Department, U.S. Army.”
Journal of Military Service Institute 14
(1893): 692-708.

Smillie, Wilson G. Public Health: Its Promise
for the Future: A Chronicle of the Develop-
ment of Public Health in the United States,
1607-1914. New York: Macmillan Co.,
1955.

Smith, Dwight L., ed. “From Greene Ville to
Fallen Timbers.” Indiana Historical Society
Publications 16 (1951-52): 239-333.

Smith, Helen Burr. “Surgeon Jonathan Potts
Planned Innoculation [sic] at the Winter
Camp.” Picket Post 16 (1947): 16-21.

Smith, Louis. American Democracy and Mili-
tary Power: A Study of Civil Control of
Military Power in the United States. Chi-
cago: University of Chicago Press, 1951.

Smith, William Henry, ed. The St. Clair
Papers. The Life and Public Service of
Arthur St. Clair, Soldier of the Revolution-
ary War; President of the Continental
Congress; and Governor of the North-
Western Territory, With His Correspondence
and Other Papers. 2 vols. Cincinnati:
Robert Clarke, 1882.

Sparks, Jared, ed. Correspondence of the
American Revolution; Being Letters of Emi-
nent Men to George Washington, From the
Time of His Taking Command of the Army
to the End of His Presidency. 4 vols. Bos-
ton: Little, Brown and Co., 1853.

Spaulding, Oliver Lyman. The United States
Army in War and Peace. New York: G. P.
Putnam’s Sons, 1937.

Sproat, James. “Extracts From the Journal of
Rev. James Sproat, Hospital Chaplain of the
Middle Department, 1778.” Edited by John
W. Jordan. Pennsylvania Magazine of His-
tory and Biography 27 (1903): 441-45.

Stahl, John M. The Invasion of the City of
Washington, A Disagreeable Study in and
of Military Unpreparedness. Argos, Ind.:
Van Trump Co., 1918.

Steiner, Walter. “Dr. James Thacher of Ply-
mouth, Mass., an Erudite Physician of
Revolutionary and Post-Revolutionary
Fame.” Bulletin of the Institute of the His-
tory of Medicine 1 (1933): 157-73.

 

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Stevens, James. “Revolutionary Journal.” Es-
sex Institute Historical Collections 48
(1912): 41-70.

Stille, Charles J. Major-General Anthony
Wayne and the Pennsylvania Line in the
Continental Army. Philadelphia: J. B. Lip-
pincott Co., 1893.

Stookey, Byron Polk. A History of Colonial
Medical Education: In the Province of New
York, With Its Subsequent Development
(1767-1830). Springfield, Ill.: Charles C
Thomas, 1962.

Sullivan, John. Letters and Papers of Major
General John Sullivan, 1771-1777. Collec-
tions of New Hampshire Historical Society,
vols. 13-15. Concord: New Hampshire
Historical Society, 1930.

Tarleton, Banastre. A History of the Cam-
paigns of 1780 and 1781 in the Southern
Provinces of North America. London: T.
Cadell, 1787.

Tatum, Howell. Major Howell Tatum’s
Journal, While Acting Topographical Engi-
neer (1814) to General Jackson, Command-
ing the Seventh Military District. Edited by
John Spencer Bassett. Northampton, Mass.:
Smith College Studies in History, 1922.

Temkin, Owsei. “The Role of Surgery in the
Rise of Modern Medical Thought.” Bulletin
of the History of Medicine 25 (1951):
248-59.

Thacher, James. American Medical Biography
. .. . Boston: Richardson & Lord and Cot-
tons & Barnard, 1828.

. American Modern Practice; Or, a

Simple Method of Prevention and Cure of

Diseases According to the Latest Improve-

ments and Discoveries, Comprising a Prac-

tical System Adapted to the Use of Medical

Practitioners of the United States. Boston:

Ezra Read, 1817.

. A Miliary Journal During the Ameri-
can Revolutionary War, From 1775 to 1783:
Describing Interesting Events and Transac-
tions of This Period: With Numerous His-
torical Facts and Anecdotes, From the
Original Manuscript. 2d ed. Boston: Cot-
tons & Barnard, 1827.

Thayer, Theodore G. Nathanael Greene, Stra-
tegist of the American Revolution. New
York: Twayne Publishers, 1960.

. “The War in New Jersey; Battles,

 

 

 
Bibliography

Alarums, and the Men of the Revolution.”
New Jersey Historical Society Proceedings,
n.s. 71 (1953): 83-110.

Thomas, Robert. The Modern Practice of
Physic: Exhibiting the Characters, Causes,
Symptoms, Prognostic, Morbid Appearances,
and Improved Method of Treating the
Diseases of All Climates. 3d American ed.
New York: Collin & Co., 1815.

Thoms, Herbert. “Albigence Waldo, Surgeon:
His Diary Written at Valley Forge.” Annals
of Medical History 10 (1928): 486-97.

Tilden, John Bell. “Extracts From the Journal
of Lieutenant John Bell Tilden, Second
Pennsylvania Line, 1781-82.” Pennsylvania
Magazine of History and Biography 19
(1895): 51-63, 208-33.

Tilton, James. Economical Observations on
Military Hospitals and the Prevention and
Cure of Diseases Incident to an Army. In
Three Parts: Addressed 1. To Ministers of
State and Legislatures, 11. To Commanding
Officers, 111. To the Medical Staff. Wilming-
ton, Del.: J. Wilson, 1813.

Tobey, James Abner. The Medical Depart-
ment of the Army. Baltimore: Johns Hop-
kins University Press, 1927.

Tompkins, Daniel D. Public Papers of Daniel
D. Tompkins, Governor of New York,
1807-1817: Military. 3 vols. New York:
State of New York, 1898.

Toner, Joseph Meredith. The Medical Men of
the Revolution With a Brief History of
the Medical Department of the Continental
Army. Philadelphia: Collins, 1876.

. “A Sketch of the Life and Character
of James Craik (1730-1814).” Transac-
tions of the Medical Society of the State
of Virginia 3 (1879): 95-105.

Torres-Reyes, Ricardo. Morristown National
Historical Park: 1779-1780 Encampment:
A Study of Medical Services. Washington:
Office of History and Historic Architecture,
Eastern Service Center, April 1971.

Trevelyan, George Otto. Saratoga and Brandy-
wine, Valley Forge, England and France at
War. The American Revolution, vol 4.
London: Longmans Green and Co., 1929.

Trumbull, John. Autobiography, Reminiscen-
ces and Letters of John Trumbull, From
1756 to 1841. New Haven: B. L. Hamlen,
1841.

 

285

Underwood, Thomas Taylor. Journal March
26, 1792, to March 18, 1800: An Old
Soldier in Wayne’s Army. Cincinnati: So-
ciety of Colonial Wars in the State of Ohio,
1945.

Upton, Emory. Military Policy of the United
States. Washington: Government Printing
Office, 1904.

Urdang, George. “Portraits of Pharmacists.”
American Professional Pharmacist 22
(1956): 801.

U.S. Congress. American State Papers: Docu-
ments, Legislative and Executive of the
Congress of the United States. Class V. Mili-
tary Affairs. Class IX. Claims. Washington:
Gales and Seaton, 1832-61.

. Journal of the Executive Proceedings
of the Senate of the United States, 1789-
1901. 32 vols. Washington: Government
Printing Office, 1828-1909.

U.S. War Department. Subject Index, 1809-
1860, General Orders, Adjutant General's
Department, Subject Index of the General
Orders of the War Department From 1
Jan. 1809 to 31 Dec. 1860. Compiled under
direction of Brig Gen Richard C. Drum by
Jeremiah C. Allen. Washington: Govern-
ment Printing Office, 1886.

Vail, R. W., ed. The Revolutionary Diary of
Lieut. Obadiah Gore, Jr. New York: The
New York Public Library, 1929.

Van Doren, Carl. Secret History of the Ameri-
can Revolution . . . . New York: Viking
Press, 1941.

Van Swieten, Gerhard. The Diseases Incident
to Armies, With the Method of Cure . . .
To Which Are Added: The Nature and
Treatment of Gunshot Wounds, by John
Ranby, Esquire, Surgeon General to the
British Army . . . . Philadelphia: R. Bell,
1776.

Van Tyne, Claude Halstead. The War of Inde-
pendence. 2 vols. Boston: Houghton Mifflin
Co., 1929. ‘

Viets, Henry R. A Brief History of Medicine
in Massachusetts. New York: Houghton
Co., 1930.

Wain, Harry. A History of Preventive Medi-
cine. Springfield, Ill.: Charles C Thomas,
1970.

Waldenmaier, Nellie Protsman. Some of the

 
286

Earliest Oaths of Allegiance to the United
States of America. Lancaster, Pa., 1944.
Waldo, Albigence. “Valley Forge, 1777-1778.
Diary of Surgeon Albigence Waldo, of the
Connecticut Line.” Pennsylvania Magazine
of History and Biography 21 (1897): 299-

323.

Walker, Adam. 4 Journal of Two Campaigns
of the Fourth Regiment of U.S. Infantry in
the Michigan and Indiana Territories, Under
the Command of Col. John P. Boyd and
Lt. Col. James Miller, During the Years of
1811-1812. Keene, N.H.: privately printed,
1816.

Walker, Alexander. Jackson and New Orleans.
An Authentic Narrative of the Memorable
Achievements of the American Army, Under
Andrew Jackson, Before New Orleans, in
the Winter of 1814, ’15. New York: J. C.
Derby, 1856.

Walsh, James Joseph. History of Medicine in
New York, Three Centuries of Medical
Progress. 5 vols. New York: National Amer-
icana Society, 1919.

Walters, Raymond. Bethlehem Long Ago and
To-Day. Bethlehem, Pa.: Carey Printing
Co., 1923.

Wangensteen, Owen H.; Smith, Jacqueline; and
Wangensteen, Sarah D. “Some Highlights in
the History of Amputation Reflecting Les-
sons in Wound Healing.” Bulletin of the
History of Medicine 41 (1967): 97-131.

Ward, Christopher. The War of the Revolu-
tion. Edited by John R. Alden. 2 vols. New
York: Macmillan Co., 1952.

Ward, Harry M. The Department of War,
1781-1795. Pittsburgh: University of Pitts-
burgh Press, 1962.

Warren, Edward. The Life of John Warren,
M.D., Surgeon-General During the War of
the Revolution: First Professor of Anatomy
and Surgery in Harvard College; President
of the Massachusetts Medical Society, etc.
Boston: Noyes, Holmes, & Co., 1874.

Warren, John. A View of the Mercurial Prac-
tice in Febrile Diseases. Boston: T. B. Wait
and Co., 1813.

Warren, John; Dexter, A.; Jackson, James;
and Warren, John C. Report on Vaccina-
tion, n.p., 1 June 1808.

Warren-Adams Letters, Being Chiefly a Cor-

THE ARMY MEDICAL DEPARTMENT,

1775-1818

respondence Among John Adams, Samuel
Adams, and James Warren. Massachusetts
Historical Society Collections, 5th ser. 72
(1917); 73 (1925).

Washington, D.C. Library of Congress. Manu-
script Division. Papers of George Washing-
ton.

 

. Papers of Isaac Foster.

Papers of Jonathan Potts, 1776-80.

Papers of Peter Turner, 1778-1812.

Papers of William Eustis, II-33-N.H.

. Papers of William Henry Harrison,

microfilm series 1, roll 1.

. Peter Force Collection, Arthur St.
Clair Papers, series 7E, box 60, folders
1782 Ag24-1793 Julé.

Washington, D.C. National Archives. List of
Officers of the Medical Department U.S.
Army 1775 to Present Date, Record Group
112, entries 83, 84, in room 201.

. Post Revolutionary War Records,

Record Group 98.

. Preliminary Inventories: War Depart-

ment Collection of Revolutionary War Rec-

ords. Washington: National Archives and

Records Service, General Services Admin-

istration, 1970.

. Records of the Adjutant General's

Office, 17805-1917, Record Group 94, Let-

ters Received by the Adjutant General 1805-

1821, Microfilm Publication M566.

. Records of the Adjutant General's

Office, 17805-1917, Record Group 94, Let-

ters Sent by the Office of the Adjutant

General, Main Series, 1800-90, Microfilm

Publication M565.

. Records of the Continental and Con-

federation Congresses and the Constitutional

Convention, Record Group 360, Papers of

the Continental Congress, 1774-89, Micro-

film Publication M247.

. Records of the Office of the Secre-

tary of War, Record Group 107, Copies of

War Department Correspondence and Re-

ports, 1791-96, Microfilm Publication T982.

. Records of the Office of the Secre-

tary of War, Record Group 107, Letters

Received by the Secretary of War, Main

Series, 1801-70, Microfilm Publication

M221.

. Records of the Office of the Secre-

||]

 

 

 

 

 

 

 

 

 

 
Bibliography

tary of War, Record Group 107, Letters

Received by the Secretary of War, Unregis-

tered Series, 1789-1861, Microfilm Publi-

cation M222.

. Records of the Office of the Secretary

of War, Record Group 107, Letters Sent to

the President by the Secretary of War,

1800-63, Microfilm Publication M127.

. Records of the Office of the Secre-

tary of War, Record Group 107, Letters

Sent by the Secretary of War Relating to

Military Affairs, 1800-89, Microfilm Publi-

cation M6.

. Records of the Office of the Secretary

of War, Record Group 107, Miscellaneous

Letters Sent by the Secretary of War, 1800-

1809, Microfilm Publication M370.

. Records of the Office of the Secre-

tary of War, Record Group 107, Registers

of the Letters Received by the Office of the

Secretary of War, Main Series, 1800-70,

Microfilm Publication M22.

. Records of the Office of the Secre-

tary of War, Record Group 107, Reports to

Congress From the Secretary of War, 1803-

70, Microfilm Publication M220.

. War Department Collection of Revo-

lutionary War Records, Record Group 93,

Miscellaneous Numbered Records, 1775-84,

series 6, Microfilm Publication M859.

. War Department Collection of Revo-

lutionary War Records, Record Group 93,

Names Index to Series 5, 6, and 9, series

4, Microfilm Publication M847.

. War Department Collection of Revo-

lutionary War Records, Record Group 93,

Numbered Record Books, 1775-98, series

5, Microfilm Publication M853.

. War Department Collection of Revo-

lutionary War Records, Record Group 93,

Revolutionary War Rolls, 1775-83, Micro-

film Publication M246, Miscellaneous, Hos-

pital Department, roll 135, folders 3-1

through 3-3.

. War Department Collection of Revo-
lutionary War Records, Record Group 93,
Subject Index to Series 5, 6, and 9.

Washington Papers. See under Washington,
D.C., Library of Congress, Manuscript
Division.

Waterhouse, Benjamin. Circular Letter From

 

 

 

 

 

 

 

 

 

 

287

Dr. Benjamin Waterhouse to the Surgeons
of the Different Posts in the Second Military
Department. Cambridge, Mass., 1817.

. The Rise, Progress, and Present State
of Medicine. A Discourse, Delivered at
Concord, July 6th, 1791, Before the Middle-
sex Medical Association. Boston: Thomas
and John Fleet, 1792.

Wayne, Anthony. “General Wayne's Orderly
Book.” Michigan Pioneer and Historical
Society Collections 34 (1904): 341-733.

Webb, James Watson, ed. Reminiscences of
Gen’l Samuel B. Webb . . . . 2 vols. New
York: privately printed, 1882.

Weedon, George. Valley Forge Orderly Book
of General George Weedon of the Conti-
nental Army Under Command of Gen.
George Washington, in the Campaign of
1777-8. New York: The New York Times
& Arno Press, 1971 reprint of 1902 edition.

Weigley, Russell F. History of the United
States Army. New York: Macmillan Co..
1967.

Welch, William Henry. “Influence of English
Medicine Upon American Medicine in Its
Formative Period.” In Papers and Addresses,
vol. 3, edited by Walter C. Burket. Balti-
more: Johns Hopkins Press, 1920.

Wells, Lloyd Allan. “Aneurysm and Physio-
logic Surgery.” Bulletin of the History of
Medicine 44 (1970): 411-24.

Wheaton, Joseph. Appeal to the Senate and
House of Representatives of the United
States of America. Washington, D.C.,
1820.

Whipple, Allen O. The Evolution of Surgery
in the United States. Springfield, Ill:
Charles C Thomas, 1963.

. The Story of Wound Healing and
Wound Repair. Springfield, Ill.: Charles C
Thomas, 1963.

White, Leonard Dupee. The Federalists: A
Study in Administrative History, 1789-1801.
New York: Macmillan Co., 1948.

. The Jeffersonians: A Study in Ad-
ministrative History, 1801-1829. New York:
Macmillan Co., 1959.

“A Whitemarsh Orderly Book.” Pennsylvania
Magazine of History and Biography 45
(1921): 205, 2109.

Whittlesey, Charles.

 

 

 

“General Wadsworth’s
288

Division, War of 1812.” Western Reserve
and Northern Ohio Historical Society
Tracts 2 (1879): 115-23.

Wickes, Stephen. History of Medicine in New
Jersey, and of Its Medical Men From the
Settlement of the Province to A.D. 1800.
Newark: Dennis, 1879.

Wilkinson, James. Memoirs of My Own Times.
3 vols. Philadelphia: Abraham Small, 1816.

Williams, John S. The Invasion and Capture
of Washington. New York: Harper & Bros.,
1857.

Williamsburg, Va. The College of William and
Mary in Virginia. Earl Gregg Swem Library.
Special Collections Division. Tucker-Cole-
man Papers, 1780-82, microfilm roll M-13.

Wilson, Frazer Ells. Arthur St. Clair. Rich-
mond, Va.: Garrett and Massie, 1944.

. Fort Jefferson: The Frontier Post of
the Upper Miami Valley: A Fascinating
Tale of Border Life Gleaned From Au-
thentic Sources and Retold by Frazer Ells
Wilson. Lancaster, Pa., 1950.

Wilson, Frazer Ells, ed. Journal of Capt. Dan-
iel Bradley: An Epic of the Ohio Frontier.
Greenville, Ohio: Frank H. Jobes & Son,
1935.

Wilson, Leonard G. “The Clinical Definition
of Scurvy and the Discovery of Vitamin C.”
Journal of the History of Medicine and
Allied Sciences 30 (1975): 40-60.

 

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Wiltse, Charles Maurice. The New Nation,
1800-1845. London: Macmillan & Co.
1965.

Winchester, James. “Papers and Orderly Book
of Brigadier General James Winchester.”
Michigan Pioneer and Historical Society
Collections 31 (1901): 253-313.

Winslow, Charles-Edward Amory. “The Colon-
ial Era and the First Years of the Republic
(1607-1799) —The Pestilence That Walketh
in Darkness.” In The History of American
Epidemiology, by Winslow, C.-E. A.; Smil-
lie, Wilson G.; Doull, James A.; and
Gordon, John E.; edited by Franklin H.
Top. St. Louis: C. V. Mosby Co., 1952.

Wistar, Caspar. Eulogium on Dr. William
Shippen. Philadelphia: Thomas Dobson and
Son, 1818.

Wolfe, Edwin P. “The Genesis of the Medical
Department of the United States Army.”
Bulletin of the New York Academy of
Medicine, 2d ser. 5 (1929): 823-44.

Woodhouse, Henry. “Colonial Medical Prac-
tice.” Ciba Symposia 1 (1940): 379-89.

Wright, Albert Hazen. The Sullivan Expedi-
tion of 1779, The Losses. Studies in History
No. 33 of New York Historical Source
Studies, 1965.

Yost, Robert. “His Book.” Ohio Archaeologi-
cal and Historical Quarterly 23 (1914):
150-61.
Index

Ackland (Acland), Maj. John Dyke, 96
Adams, John, 28-29, 35, 37, 39, 60, 82
Adams, Samuel, 28, 35, 44, 60, 62, 82
Adams, Samuel, Jr., 51, 52, 66, 72, 74, 92
Adjutant General, 81, 152, 155, 230
Alabama, 181

Albany, N.Y., 48, 57, 63-64, 94-97, 106,

114, 127, 133, 144, 148-49, 155, 150-91
Alcoholic beverages. See Wine and spirits.
Alexandria, Va., 75, 84, 120
Alison, Francis, 107, 112
Allentown, Pa., 70-71, 81, 91
Allison, Richard, 133, 134, 136-37
Amboy, N.J., 69, 77
Ambulances, 167
Amputations, 7, 15-18, 84, 138, 151, 195-96
Andrews, Joseph Gardner, 139-40
Annapolis, Md., 148
Anthrax, 151
Apothecaries, 8, 33. See also Hospital Depart-

ment; Medical Department.

Armstrong, John, 148
Army, Revolutionary War. See Continental Army.
Army, 1783-1812. See also Regiments.
coastal and interior forts, 138-40
Indian campaigns, 131, 133-38
Louisiana Territory operations, 140-43
organization of, 129-32, 134-35, 137-38, 140.
144
Army, War of 1812
Military Districts, 150-51. 154.
177-85, 190, 195-96
Northern operations, 148, 157, 159-71, 172-78
organization and strength, 148-49, 153, 157.
159, 161-63, 172, 178, 180-81, 184-85
Southern operations, 164, 178-85
Army, post-War of 1812, 186-87, 190
Army medical organization, 197. See also Hospital

Department: Medical Department; Medical

personnel.

Arnold, Maj. Gen. Benedict, 59-60, 64, 96
Articles of Capitulation, 123

Ashley, S.C., 124

Aspinwall, William, 51

Asthma, 65, 96, 111

Auenbrugger, Leopold, 3

Autopsies, 19, 140, 194-95

166-67, 172.

Backus, Christopher, 184
Baltimore, Md., 70, 75, 110, 172, 178, 180, 188
Bard, John, 15
Bard, Samuel, 8
Bartlett, John, 38, 95
Barton, William, 196, 266
Basking Ridge, N.J., 103, 111, 243, 245
Beaumont, William, 160, 167, 170
Beaverdam, Va., 120
Bedford, N.Y., 112-13
Bell, Whitfield Jenks, Jr., 29, 42
Benedict, Md., 178
Bennington, Vt., 94-95
Bethlehem, Pa., 42, 70-71, 80-83, 88-89, 91, 238
Bettering House (Philadelphia), 70, 109
Binney, Barnabas, 29, 44, 48, 67
Black Rock, N.Y., 165, 169
Bladensburg, Md., 180
Blaine, Ephraim, 83
Bleeding, 1-2, 14-18, 159-60, 193-95
Blistering, 1, 5, 7, 17-18, 159-60, 192, 194
Blood, Hosea, 175
Bloomfield, Moses, 44
Board of Treasury, 31, 40, 43
Board of War, 25, 45, 48, 118, 230
Boerhaave, Hermann, 1
Bond, Nathaniel, 75
Bond, Thomas, Jr., 40, 42-44, 46, 82, 109-10, 228
Bordentown, N.J., 72, 81
Boston, Mass., 26-28, 30, 48, 50-57, 74,
144, 152, 154, 188, 193
Boswell, James, 29
Boulden, Nathan, 177
Bound Brook, N.J., 102
Brandywine Creek, 79-80, 90
Bristol, Pa., 79, 81
British Army, 3-4. See also Prisoners of war.
commanders, 28, 40, 47, 80, 94-95, 120-21
Medical Department, 8, 20-21, 36-37, 46-47,
82, 95
in Revolutionary War, 33, 50, 56-57, 59, 67,
71-73, 77-80, 92, 94, 97, 99, 109, 117-19,
120-25
in War of 1812, 148, 153, 161-62, 164-65, 168,
172-73, 177-81
British Navy, 57, 64, 77, 181
Brocklesby, Richard, 4, 6, 20

114,
290 THE ARMY MEDICAL

Brodhead, Col. Daniel, 106, 108, 110

Brookline, Mass., 51

Brown, Maj. Gen. Jacob, 172, 175

Brown, William, 69, 82, 89, 102, 239

Browne, James, 118

Brownville, N.Y., 175, 188, 190, 196

Brunswick, N.J., 69, 77, 99, 102, 110

Buckingham, Pa., 81

Buffalo, N.Y., 152, 161, 164-65, 169, 175

Bull, E. W,, 177

Burgoyne, Maj. Gen. John, 40, 94-95

Burlington, N.J., 81

Burlington, Vt., 156, 157, 161, 167, 172-74, 188,
190, 194, 197

Burnet, William, 38, 44, 67, 98, 99, 102

Burr, Aaron, 140

Calhoun, John, 186-87
Cambridge, Mass., 22, 27, 29, 51, 52-53
Camden, S.C., 117
Canada
Revolutionary War, 20, 32-33, 50, 57, 59-60
War of 1812, 148, 153, 157, 159-67, 170, 172
Canajoharie, N.Y., 106
Capitol Hill hospital, D.C., 180
Carleton, Sir Guy, 47
Carlisle, Pa., 84
Carmichael, John F., 135-36, 139
Carolinas, 75, 103, 115, 120, 185
Casualties
Indian campaigns, 134, 136, 138
ratio of disease vs. wounds, 3, 8, 39, 108
Revolutionary War, 67, 69, 71-72, 108, 119,
121-23
War of 1812, 163-65, 168, 170, 172, 175, 177,
180
Catlett, Hanson, 180, 194, 262
Chadd’s Ford, Pa., 79
Charleston, S.C., 115, 117-19, 121, 123-24, 152
Charlotte, N.C., 118-19, 123
Charlottesville, Va., 120
Cheraw, S.C., 118
Cherry Valley, N.Y., 106
Chesapeake Bay, 79
Cheselden, William, 15
Chesterfield Court House, Va., 120
Chippewa, battle of, 175, 177
Chippewa River, 172
Cholera, 96
Church, Benjamin, 26-28, 30, 35, 38, 46, 51, 52,
56
Cincinnati, Ohio, 134, 136-37
Claiborne, Governor, 183
Clark, James, 17
Clinton, Brig. Gen. James, 106, 108, 114
Clothier General, 40, 83
Clothing, 9-10, 40, 66, 73, 160, 191-92

DEPARTMENT,

1775-1818

Clothing shortage, 3, 22, 30, 39, 62, 77, 82-83,

85, 88, 92, 99, 103, 109, 114, 124, 134,
169-70
Cochran, John, 14
Director General of Hospital Department,

44-48, 105-6, 112, 121, 125-27
and Hospital Department reform, 36-37
Physician and Surgeon General, Middle Depart-
ment, 38, 40, 42, 71-72, 74
Physician and Surgeon General of the Army,
43-44, 77-79, 82, 84-87, 92, 102, 105, 120,
236
Colchester, Va., 75, 120
College of William and Mary, 120, 122
Committee of Correspondence (Boston), 26
Committees of Safety, 26
Conanicut Island, R.I., 115
Congress, Revolutionary War, 82
and Hospital Department funding, 30, 39-41,
44, 119
Hospital Department legislation and regulation,
22, 25-41, 43, 45, 48, 74-75, 109, 115-18,
127, 228
and Hospital Department staff, 34-35, 41-44,
46-49, 59-60, 64, 69
Medical Committee, 14, 25, 35, 37, 40, 43-45,
72, 75, 77, 105, 110, 114
Secret Committee, 224
and supply problems, 39-40, 42, 46, 57, 59,
62-65, 83
Congress, 1783-1812, 131, 135
Congress, War of 1812, 149, 156
Congress, 1815-1816, 187
Connecticut, 57, 103, 113, 150. See also Hospital
patients.
Connecticut Provincial Congress, 28, 56
Continental Army. See also Hospital Department;
Washington, George.
Boston operations, 50, 56-57
commanders, 37, 50, 57, 59-60, 67, 98, 119-20
desertions, 59, 91, 111, 119
disbandment of, 48, 99, 133
enlistment problems, 27, 33, 59, 74-75, 84
mutinies, 31, 46, 103, 105, 124
New Jersey and Pennsylvania operations, 39, 50,
67-72, 92, 103, 110
New York area operations, 45, 50, 57, 65-67,
69, 72-74, 99
Northern Army operations, 50, 57, 59-60, 98,
108
smallpox and inoculation, 56, 62, 74-75, 84
strength of, 33, 50, 59-60, 65, 70, 75, 77, 87,
95, 106, 121, 124
at Valley Forge, 81-82, 84-87, 92
Yorktown operations, 46, 112, 120-23, 127
Coosa River, 181
Cornwallis, Lt. Gen. Charles, 121
Index

Council of War, 28
Crab Island, N.Y., 174
Craigie, Andrew, 44, 60, 63, 82-84
Craik, James, 40, 43-44, 82, 87, 92, 105, 115,
121-22, 126
Crawford, William H., 187
Creek Indians, 164, 181
Croton River, 73
Crown Point, N.Y., 60
Cullen, William, 1-2, 19, 54
Cunningham, Cornelius, 165
Cupping, 194
Cutbush, Edward, 11, 220
Cutbush, James, 156
Cutter, Ammi Ruhamah, 38, 98
Cutting, John Brown, 67, 82-84, 237
Cuyahoga, 162
Danbury, Conn., 98, 102, 112-13
Dartmouth medical school, 20
Dayton, Ohio, 162
Dearborn, Maj. Gen. Henry, 129, 148, 157, 161,
165, 167
Delaware, 91-92, 125, 150
Delaware Indians, 140
Delaware River, 73, 92
Detroit, Mich., 137, 148, 162-63, 165, 190, 194
Diarrhea, 5, 7-8, 73, 96, 111, 114, 122, 125,
127, 139, 142-43, 157, 167-70, 173, 178,
192-93, 195, 254, 260
Dimsdale, Baron, 56
Diphtheria, 4
Director General and Chief Physician, Hospital
Department. See also Church, Benjamin;
Cochran, John; Foster, Isaac; Morgan, John;
Shippen, William, Jr.
appointments and dismissals, 26, 28-29, 35-37,
43-44, 75, 77
authority of, 22, 23, 27, 29, 32, 36-37, 41,
45, 98, 115, 117
supply powers, 37, 39-40, 43

Disease. See also Casualties; Disease rates;
Diseases.
diagnosis of, 1, 3-6
theories of cause and spread, 1-4, 77, 141,

186, 192-93
treatment of, 1, 5-11, 14, 159-60, 191-95
Disease rates
Indian campaigns, 132, 134-37
Louisiana Territory, 141-43
Northwest Territory forts, 139-40
Revolutionary War, 59-60, 63, 70 75, 77, 84,
88-92, 94-97, 102-3, 105-6, 108, 128, 230,
240-41
War of 1812, 157, 159-62, 165, 170, 173
Diseases, 7-8, 10, 65, 96, 114, 127-28, 140-42,
160, 192, 254. See also Fevers; and specific
name of disease.

291

District of Columbia, 178

Doctors’ Mob riot, 19

Downingtown, Pa., 109

Draper, George, 44

Dropsy, 7, 96, 193, 195

Drugs, 29, 57, 187-88. See also Medical and

hospital supply; Medicine chests; Medicines.

imported and purchased, 26, 39-40, 46, 82
lists of requirements, 6-7, 63
shortages, 22, 25-26, 30, 56, 60, 62-64, 82-84

Dumfries, Va., 75, 120

Dunkards, 90-91

Dunkerstown, Pa., 90

Dysentery, 3-5, 7, 9, 11, 56, 60, 63, 84, 96, 108,

111, 113-15, 123, 125, 139, 142-43, 157,
159-61, 168, 170, 173, 178, 184, 192-93,
195, 260

Eastern Department (Hospital Department)
hospitals, 48, 50, 53, 57, 66-67, 72-76, 97-98,
108, 114, 125-26
medical staff, 36-38, 40, 69, 74, 97-98, 99, 102,
112, 230
supply, 56, 66-67, 70-73, 81, 98, 99
Easton, Pa., 70-71, 81-82, 91, 106-8
Edwards, Abraham, 162
Elizabeth, N.J., 69
Elliott, John, 133, 134
Ephrata, Pa., 81, 90-91
Epilepsy, 194
Erie, N.Y, 152
Ettwein, John, 70, 81, 88, 91
Eustis, William, 44, 72-73, 113, 126, 129, 134,
141-42, 144, 148-50, 243, 246
Eutaw Springs, S.C., 119, 123
Evacuation of patients, 21, 87-89
land transport, 72, 77, 81, 118, 136, 167, 169
water transport, 67, 94, 102, 108, 123, 125,
138, 142, 162, 167, 170, 173-75
Evansburg, Pa., 81
Ewell, James, 180

Fallen Timbers, battle of, 131, 136
Faulkner Swamp, Pa., 81
Fayssoux, Peter, 45, 118-19, 123
Fever
causes and diagnosis of, 2, 4, 7, 193
incidence of, 52, 60, 76, 96, 190, 192
treatment of, 2, 7-8, 63, 194
Fevers, by type
autumnal, 56, 137
bilious, 3, 63, 96, 111, 120, 126-27, 137, 142-43
bilious putrid, 112-13, 127
camp, 69
hospital, 4, 218
inflammatory, 125, 127, 143, 193-94
intermittent, 4, 63, 96, 103, 106, 111, 113-14,
292

Fevers, by type—Continued

120, 122, 125-26, 138-40, 142-43, 157,
159-60, 167-68, 178, 193-94
jail, 4, 218

malignant, 4
pernicious, 184
putrid, 4, 61, 77, 79, 81, 84-85, 88, 90-91,
95-96, 103, 113, 126-27, 137, 218
remittent, 4, 63, 106, 113-14, 120, 122, 125-26,
140, 142-43, 193
scarlet, 4
spotted, 159
typhoid, 4-5, 84, 143, 160, 193, 218, 265
typhus, 4-5, 7, 21, 84, 110, 140, 157, 159, 163,
168-70, 173, 193-94, 218, 265
yellow, 3-4, 7, 143, 193
Fishkill, N.Y., 73-75, 97-98, 102, 112
Flood, (Doctor), 184
Florida, West, 164, 181
Food shortages, 3, 22, 39-40, 42, 46, 63-64, 71,
82-83, 91, 99, 103, 105, 114, 117, 124, 134
Food supply
barley, 7, 159
bread, 63, 77, 83, 103, 137, 159, 165, 168
chocolate, 7, 83, 142, 155, 159, 170
coffee, 7, 83, 114
cornmeal, 63, 83, 149
flour, 83, 103, 141, 170
fruit, 8, 11, 14, 97, 193
meat, 11, 63, 65, 83, 91, 115, 126, 137, 159-61,
193
milk, 91, 108, 160, 169, 193
molasses, 7, 63, 85, 114, 124, 159
rice, 7, 63, 83, 114, 159
salt, 6, 83
sugar, 7, 11, 42, 64, 83, 114, 124, 140, 142,
159
tea, 83, 114, 124, 142, 159
vegetables, 11, 14, 39, 64-65, 77, 92, 94, 113,
115, 136-37, 193
vinegar, 7, 39, 77, 83, 149
Forgue, Francis, 38, 233
Fort Adams, Miss., 139, 141-42
Fort Anne, N.Y., 94
Fort Constitution, 166
Fort Dearborn, Ill., 162-63
Fort Defiance, Ohio, 136-37, 139-40, 163
Fort Erie, 177
Fort Fayette, Pa., 162
Fort George, N.Y., 59-60, 62-65, 94, 165, 168-69
Fort Harrison, Ind., 138
Fort Independence, 166
Fort Jay, N.Y. 138
Fort Jefferson, Ohio, 134, 140
Fort Knox, 138
Fort Lee, N.Y., 69, 73
Fort Malden (Canada), 162-64

THE ARMY MEDICAL DEPARTMENT,

1775-1818

Fort McHenry, Md., 180
Fort McNair, D.C., 180
Fort Meigs, Ohio, 6, 164-65
Fort Nelson, Va., 185
Fort Niagara, 161-62, 165, 168
Fort Pitt, Pa., 106, 110, 133
Fort Preble, 166
Fort Schlosser, N.Y., 169
Fort Seammel, 166
Fort Stephenson, Ohio, 177
Fort Stoddert, Ala., 181
Fort Strother, Ala., 181
Fort Sullivan, N.Y, 108, 110, 166
Fort Sumner, 166
Fort Washington, N.Y., 72-73
Fort Washington, Ohio, 134, 136-37, 139
Fort Wayne, Ind., 133, 139
Forts and garrisons
coastal, 138
Northwest Territory, 131, 136, 139
Foster (Forster), Isaac, 28, 38, 46, 51, 57, 66-67,
74-75, 97-98, 99, 102, 112
Foster, Josiah, 137-38, 162
France. See also French forces.
fear of war with (1791), 131, 138, 148
funds and supply from (Revolutionary War),
26, 30, 46, 49
Franklin, Benjamin, 6-7, 54, 192
Fraser, Brig. Gen. Simon, 95
Fredericksburg, Va., 120, 194
French and Indian War, 20, 44, 64, 75
French Creek, Pa., 109
French forces, 40, 46, 106, 115, 121-23
French Mills, N.Y., 156, 166, 170, 174
Frenchtown, Mich., 163
Frostbite, 84, 163, 167
Frothingham, Ensign, 140

Gage, General Thomas, 28

Gangrene, 16

Gates, Maj. Gen. Horatio, 54, 60, 62-65, 95-97,
117, 227, 240-41

Genesee, N.Y., 106, 108

Georgia, 43, 115, 117, 150, 185

Germantown, Pa., 79, 81-82

Gould, David, 120

Governors Island, N.Y., 138

Grasse, Rear Admiral de, 106

Grasson, Victor, 134, 251

Great Britain, fear of war with (1791), 131, 138,
140

Green Spring, Va., 121

Greenbush, N.Y. 157,
188

Greene, Maj. Gen. Nathanael, 66-67, 81, 83,
118-19, 123-24

Greenleaf’s Point, D.C., 180

159-61, 169, 171, 175,
Index

Greenville, Ohio, 134, 137
Gregg, Captain, 114
Hackensack, N.J., 69, 72
Hagan, Francis, 44, 94
Hampton, Maj. Gen. Wade, 142, 166, 170
Hancock, John, 82
Hanover, Va., 120-21, 123
Harmar, Brig. Gen. Josiah, 131-33
Harrison, Maj. Gen. William Henry, 6,
137-38, 152, 156, 163-65, 177
Hartford, Conn., 98, 113
Harvard medical school, 20
Hays, Adam, 177
Hayward, Lemuel, 51
Hayward, Nathan, 133, 136
Head of Elk, Md., 125
Heath, Maj. Gen. William, 47, 73-74, 103
Heerman, Lewis, 184
Henry, Patrick, 54, 75
Hessian troops, 71-72, 94-96
Heustis, Jabez, 143, 192-93
Heyward, Thomas, Jr., 33
High Hills of Santee, S.C., 199, 123
Highlands of the Hudson, N.Y., 103
Hillsboro, N.C., 118
Horner, W. E., 196
Hosack, David, 3
Hospital Department. See also Director General
and Chief Physician; Eastern Department;
Middle Department; Northern Department;
Southern Department.
Apothecary General, 30, 40, 44-45, 67
Apothecaries General, 37, 60, 65, 69, 82, 84,
237
British system as model for, 20, 36
close of, 48, 99, 127, 133
conflict with regimental system, 8, 26-27, 29-32,
40, 45, 48, 72
Deputy and Assistant Directors General, 36-40,
43, 45, 65, 82, 97, 112, 114, 118, 120, 233
internal staff disputes, 19-21, 26, 29, 32-35,
38-39, 41-43, 48-49, 62, 67, 69-70, 112
legislation and reform, 22-41, 43, 48, 74-75,
77, 109, 115, 117-18, 127
Physician and Surgeon General, 43-45, 77, 82,
236
Physicians and Surgeons General, 36-37, 40,
43-45, 60, 65, 69, 82, 89, 95, 97-98, 102,
108, 114, 118
Purveyor, 39-40, 43-46, 82, 118
staff education and experience, 1-2, 9, 19-21,
22, 38
staff pay and allowances, 27, 41, 43, 45-49
staff selection and promotion, 22-26, 43, 45, 47,
60
Hospital patients. See also Evacuation.
care of, 9, 15-18, 151

131,

293

Hospital patients—Continued

civilian, 91, 97, 106, 112, 114-15, 125, 127,
139, 177

diet, 2, 11, 15, 66, 85, 119, 141, 159-60, 170,
193

new recruits, 3, 10, 69, 102, 159, 168, 178

prisoners of war, 80, 94-96, 110, 113, 121, 127,
153, 164, 175, 177, 180-81, 184-85, 190

segregation and isolation of, 9, 37, 51, 56, 64-65,
74-75, 106, 109, 120, 123, 197

Hospital patients, Revolutionary War

Connecticut, 72-73, 98, 113

Delaware, 91, 125

Maryland, 125

Massachusetts, 22, 26, 27, 51, 52-57, 98, 114

New Jersey, 67, 69, 71-72, 75, 81, 99, 102-3,
126-27

New York City and Long Island, 66-67, 74

New York State, 57, 59-60, 62-65, 72-74, 92,

94-98, 102-3, 105-6, 108, 110, 112-14,
125-27

Pennsylvania, 69-71, 76, 77, 80-84, 86, 88-92,
106-12, 127

Rhode Island, 98, 115
South Carolina, 117-19, 123-24
Vermont, 94-95
Virginia, 84-85, 120-23
Hospital patients, 1783-1812
Louisiana Territory, 141-43
Northwest Territory, 133, 134-40
Hospital patients, War of 1812
District of Columbia, 180
Louisiana, 183-84
Massachusetts, 190
New York State, 157, 159-62, 167-71, 173-75,
178
Northwest Territory, 162-65, 177-78, 194
Vermont, 167, 172-74, 178
Virginia, 185
Hospitals. See also Medical personnel.
closings of, 48, 64, 91, 94, 108-9, 113, 123,
127, 133
convalescent and invalid, 51, 52-53, 88, 133,
188
design and siting of, 9, 65, 86, 87, 115, 126,
154, 167-69, 175, 196-97
discipline, 9, 39, 50-52, 54, 66, 81, 87, 91, 102,
105, 109-11, 129, 136, 154, 178, 180, 190-91
European, 8, 48
funds for, 30-31, 35, 39-41, 44, 110, 114, 119,
155
guards, 9, 20, 52, 69-70, 122, 138, 159
huts and tents, 86, 92, 94, 102-3, 106, 111-12,
135, 137, 141, 157, 163, 166, 168-70, 175,
195-97, 243
inspector general, 9, 36-37
management of, 8-9, 66-67, 128, 171, 185, 197
294 THE ARMY MEDICAL

Hospitals—Continued
matrons, 45, 135
nurses, 8, 31, 45, 64, 66-67, 70-71,
94-96, 109, 117, 119, 121, 135, 150,
159, 183, 185, 197
in public and private buildings, 48, 65, 70-72,
81, 86, 94, 96-97, 99, 102, 112, 115, 120-24,
163, 165, 167, 174, 183
reporting requirements, 31, 41, 53, 66, 77, 81,
87, 105-6, 125, 151, 154, 172, 175-77,
184-85, 197, 230
sanitation, 3, 8-10, 20, 73, 92, 120, 122, 151.
154, 167-68, 173, 196-97
for smallpox and inoculation, 56, 64, 74-75,
106, 120, 123
stewards, 31, 40, 45, 65, 149, 159
storekeepers, 31, 39, 66
wardmasters, 40, 151, 159
Hospitals, flying, 8, 34, 44, 69-70, 85-87, 92, 95,
99, 102, 105-8, 112, 119-21, 125-26, 169,
177, 230, 243, 245
Hospitals, general, Louisiana Territory, 140
Hospitals, general, Revolutionary War, 8, 26-27,
31, 36-37, 43, 64-67, 86-88, 91-92, 95,
102, 106-8, 111, 114, 117, 120-21, 126, 230.
245
Hospitals, general, War of 1812, 150,
164, 167-69, 172-75, 177, 180
Hospitals, regimental, Revolutionary War, 8,
22-27, 31, 35-37, 40, 43, 45, 63-64, 85-86,
102, 105-6, 125, 230
Hospitals, regimental, War of 1812, 170. 172-74,
172
Howe, General William, 77, 80
Hudson River, 34-36, 73-75, 77, 96-97.
105-6, 112-13, 126, 138, 160
Hull, Brig. Gen. William, 148, 162-63, 165
Hunter, John, 5, 7, 14-19, 54
Hunter, William, 15, 19
Huntt, Henry, 172, 190, 195
Hygiene, personal, 9-11, 22, 50, 82, 154, 191

91-92,
154.

153-54,

103,

Indian-Loyalist forces, 106, 108, 114

Indiana Territory, 137

Indians, 106, 108, 110, 114, 129, 131, 133-38, 140,
148, 162-65, 181, 190, 197

Infection. See also Hospital patients; Hospitals.
3, 8, 17-18, 109, 167, 186

Inoculation, 14, 23, 32, 56, 59, 62-64, 74-75,
84-85, 97-98, 102, 115, 120, 125-27, 135

Invalid Corps, 127, 133

Izard, Maj. Gen. George, 172-73, 175, 191

Jackson, Maj. Gen. Andrew, 164, 181, 183-84
Jackson, David, 44
Jaundice, 21, 63, 96, 168, 178

DEPARTMENT,

1775-1818

Jenner, Edward, 14

Jockey Hollow, N.J., 103, 243
Johnston, Robert, 97, 114
Johonot, William, 44

Jones, John, 10-11, 14-20
Jones, Walter, 38

Jones, William, 180

Journal de Médicine Militaire, 20

Kalb, Baron de, 84

Kennedy, Samuel, 87-89

Kentucky, 150

Kerr, David, 183-84

Kerr, John, 184

King's College medical school, 20, 65
King's Mountain, battle of, 118
Kingsbridge, N.Y., 73

Knox, Brig. Gen. Henry, 47, 111

Lafayette, Marquis de, 112, 115, 121

Lafayette, Ind., 138

Lake Champlain, 37, 64, 94, 157, 166, 172, 174,
190

Lake Erie, 161-62, 164-65

Lake George, 59, 63

Lake Ontario, 161, 174, 190

Lancaster, Pa., 81

Larrey, Dominique, 196

Latimer, Henry, 44, 89, 125

LeBaron, Francis, 144, 148-49,
187-88, 190-91

Le Dran, Henri Frangois, 20

Ledgard, Isaac, 44

Lee, Maj. Gen. Charles, 51, 57, 73

Lee, Richard Henry, 35-36, 70, 72, 82

Leeches, 194

Leesburg, Va., 121

Lewis and Clark Expedition, 133

Lewiston, N.Y., 161, 168-70, 175, 195

Lexington, battle of, 28

Lincoln, Maj Gen. Benjamin, 45, 117, 120

Lind, James, 11

Lititz, Pa., 81, 83, 89-91, 109, 239

Lockjaw, 165

London, 19, 26, 38

Long Island, N.Y., 65-67, 69

Louisiana, 140, 150, 181. See also Hospital pa-
tients.

Lovell, Joseph, 161, 167, 187, 190-92, 194, 197,
260

Lower Sandusky, Ohio, 177

Lundy’s Lane, battle of, 172, 175

152, 155-56,

MacKenzie, Samuel, 70, 75, 95
Madison, James, 149

Maggots, 60, 96, 119

Malaria, 3-5, 122-25, 137, 142, 194, 254
Index

Malone, N.Y., 167, 169-70, 174
Manheim, Pa., 83-84
Mann, James, 157, 159-61, 167-69, 171-74, 187,
190, 192-97
Martin, John R., 152-53
Maryland, 31, 70, 72, 74-75, 125, 150. See also
Hospital patients.
Massachusetts, 26-28, 48, 50-51, 74, 150, 166.
See also Hospital patients.
Massachusetts Provincial Congress, 26-28, 56
Maumee River, 162-64
McClurg, James, 120
McCrea, Doctor, 108
McDowell, Ephraim, 15
McHenry, James, 52, 60. 62, 129, 137
McIntosh, Brig. Gen. Lachlan, 91-92
McKnight, Charles, 43-44, 51, 52, 66, 72, 74, 81,
112
Mease, James, 144
Measles, 65, 96, 126, 159-61
Medical Department, 1783-1812,
157
Medical Department, War of 1812, 149-50, 153,
156-57, 159, 174-75, 177-78, 181, 184-86,
191
Apothecary General, 149-50, 152, 155-56, 174
Physician and Surgeon General, 149-52, 170-
71, 186
Medical Department, post-1812
Apothecary General, 184, 186-88, 190-91
permanent department, 186-88, 190-91, 198
Surgeon General, 187
Medical and hospital supply, Revolutionary War.
See also Drugs; Medicine chests; Medicines.
Commissary General, 40, 65-66, 83, 233
imported, 26, 30, 40, 46, 49, 75
purveyors, 8, 36-37, 39-40, 43-46, 82, 118
shortages, 25, 29-32, 38-42, 44-46, 48, 56-57,
59-60, 62-64, 66-67, 70-73, 82-84, 88, 94-
96, 98, 99, 103, 109, 113-14, 117-19, 121-
23, 125-26, 197
sources, 25-26, 30, 39-40, 46, 49, 56-57, 69,
75, 82-83, 110
Medical and hospital supply, 1783-1812
attempts to improve, 144
depots, 139, 144, 148
forts and garrisons, 139-40
Indian campaigns, 132, 134-37
Louisiana Territory, 141-42
purveyor, 129, 144
Medical and hospital supply, 1812-1816
Apothecary General, 152, 155, 187
Commissary General, 150, 155
depots, 148, 155-56, 159, 188
purchasing of, 149-50, 154-55
purveyor and inspector, 148
reform, 188, 190

129-33, 155,

295

Medical and hospital supply, 1812-1816—Continued

shortages, 155, 162-65, 170, 172, 174, 184, 197
Medical literature, 20, 186, 191, 196

Medical personnel, 1, 129, 144, 170-72, 185, 186,

190-98. See also Hospital Department; Hos-
pitals; Medical Department; Physicians;
Surgeons.

Army surgeons and mates, Revolutionary War,
27, 32-33, 36, 44-45, 65-66, 72, 90, 92, 95,
108, 114

garrison surgeons and mates, 1783-1812, 131,
138-39

garrison surgeons and mates, War of
151-53, 166, 177-78, 181, 185-87

hospital surgeons and mates, Revolutionary War,
27, 30-33, 40, 43-44, 47, 59, 66-67, 69,
87, 92

hospital surgeons and mates, 1783-1812, 133,
140, 148

hospital surgeons and mates, War of 1812, 150-
52, 159, 170, 174, 177-78, 180-81, 185-87

and line officers, 37, 41, 47, 49, 79, 129, 133,
159, 173, 228

militia surgeons and mates, 137, 148, 153, 164

pay and allowances, 27, 32, 36-37, 41, 46-48,
64-67, 109, 133, 150-54

regimental surgeons and mates, Revolutionary
War, 26-27, 30-32, 37, 40-41, 45, 59-60,
63-64, 66-67, 69, 72, 77-79, 80-81, 94-95,
98-99, 102-3, 106-8, 117, 125

regimental surgeons and mates, 1783-1812, 129,
131-35, 140

regimental surgeons and mates, War of 1812,
148, 150-51, 153, 164, 169-70, 172-74, 177,
180-81, 186

Medical Sketches (Mann), 197
Medical societies, 20
Medical training, 1, 102, 151, 164, 198-99

American medical colleges, 18-20

by apprenticeship, 19, 38, 44

European, 15, 18-20, 26, 38

examination boards, 26, 45, 47, 129, 150, 154

Medicine, 1, 128, 186, 197. See also Medical per-
sonnel.

Medicine chests, 30-31, 57, 83-84, 135, 148-49,
155-56

Medicines, 234. See also Drugs.

antimony, 6, 14, 169, 195

arsenic, 57, 194

bark, 6, 9, 16-17, 57, 62-63, 119, 124, 137,
144, 160, 194, 254

calomel, 2, 6-7, 17, 159-60, 192, 195

camphor, 6, 9, 63

castor oil, 7, 192

corrosive sublimate, 6-7

cream of tartar, 57

digitalis, 160

1812,
296 THE ARMY MEDICAL

Medicines—Continued
emetics, 5-6, 124, 160, 192
ipecac, 6, 57, 63, 192
jalap, 2, 6, 62-63, 160, 192
manna and senna, 6, 192
mercury, 6-7, 14, 18, 143, 194-95, 254
nitrate of silver, 194
nitre, 6, 63
opium, 5-6, 8, 16-18, 62, 122, 137, 159-60,
192-93, 195, 254
purgatives, 6-7, 159-61, 192-93
quinine, 3, 16
rhubarb, 6, 192
salts, 7, 62, 192
sugar of lead, 193, 195
sulfur, 6, 83-84
tartar emetic, 6, 63, 192
vegetable remedies, 63, 66, 143, 144
Mercer, Brig. Gen. Hugh, 33, 34, 69, 72
Miami Indians, 134, 163
Michilimackinac, Mich., 190
Middle Department (Hospital Department)
hospitals, 67, 69-72, 74, 77, 79-92, 97-99, 108,
110
medical staff, 36-37, 39-40, 44, 82, 84, 89, 102,
108, 112, 115, 237
supply, 67, 70-72, 81-84, 98, 99, 109-10, 114
Middlebrook, N.J., 102, 110-11
Middleton, Peter, 9
Military Journal (Thacher), 114
Mississippi River, 141-42
Mississippi Territory, 150, 164, 181
Mobile, Ala., 164
Mohawk River, 106, 188
Monmouth, N.J., 92, 99, 110
Monro, Donald, 4, 6, 8, 11, 54, 80
Monroe, Mich., 163
Montgomery, Brig. Gen. Richard, 59
Montreal, 59-60, 157, 159, 165, 170
Montresor’s Island, N.Y., 66, 74
Moravian Order, Bethlehem, Pa., 70-71, 80-83,
88-91
Morgan, John, 20, 44
as Director General, Hospital Department,
29-32, 36, 38-39, 51, 54-57, 60, 62, 66-67,
69-70, 72-74, 83
dismissed, 29, 74-75
feud with Shippen, 19-20, 29, 33-35, 42-43, 67,
224
power struggle with Stringer, 32-33, 62
Morris, Robert, 45-46, 110
Morristown, N.J., 50, 69, 71, 75, 99, 103, 111-
12, 243
Mortality rate
Louisiana Territory, 141-43
Revolutionary War, 3, 48, 53, 57, 82, 86, 88, 91,
95, 99, 103, 124

DEPARTMENT,

1775-1818

Mortality rate—Continued
from smallpox and inoculation, 14, 75, 115
from surgery, 17-18, 196
War of 1812, 161-63, 169-70, 172-75, 184
Mosquitoes and nets, 4, 124, 139, 142-43
Mount Holly, N.J., 81
Mount Independence, N.Y., 64-65, 92
Mumps, 194

Napoleonic Wars, 21, 167
Narragansett Bay, 115
Natchez, Miss., 139, 141-43
Natchitoches, La., 181
Navy, American, 129, 155, 164, 170, 172, 174
Negroes, 117, 125
New Boston, N.Y., 126
New England, 37, 50, 72, 113, 122, 138, 166
New Hackensack, N.Y., 113
New Hampshire, 56, 106, 150, 166
New Jersey, 34, 50, 67, 69-73, 75, 77, 79, 108,
110-11, 150. See also Hospital patients.
New London, Conn., 98, 113, 152
New Orleans, La., 140-42, 152, 155-56, 172, 181,
183-84, 188, 263
New Windsor, N.Y., 103, 112-13, 125-26
New York City, 33-34, 50, 56-57, 60, 65-67, 72-
73, 99, 106, 113, 138, 144, 152, 188
New York State, 47, 72, 105-6, 121, 150, 164-66.
See also Hospital patients.
Newark, N.J., 67, 69
Newark, N.Y. 169-70
Newport, Del., 92
Newport, R.I., 98, 102, 115
Newtown, Pa., 71, 74, 108
Niagara, N.Y., 148, 157, 159, 190
Niagara River, 162, 165, 169, 172, 175, 177, 194
Norfolk, Va., 152, 185
North Anna River, Va., 121
North Carolina, 43, 115, 117-19, 150
North Castle, N.Y., 72
Northampton, Pa., 81
Northern Department (Hospital Department)
hospitals, 59-60, 62-65, 94-97, 108, 114
medical staff, 27, 32-34, 36-38, 40, 57, 59-60,
62-65, 81-82, 95, 97, 102, 114, 233
supply, 22-26, 30, 57, 59-60, 62-64, 83-84,
94-96
Northwest Territory, 133-38, 150, 157, 163-66,
170, 177. See also Hospital patients.
Norwalk, Conn., 72-73
Nottingham Meeting House, Del., 92

Ohio, 137, 150, 152, 162-63

Oliphant, David, 45, 117-19

Ophthalmia, 96, 111

Otterkill, N.Y., 113

Otto, Bodo, 44, 69-70, 75, 79, 87, 92, 109
Index

Otto, Frederick, 79, 87
Otto, John Augustus, 79, 87

Paoli, Pa., 79
Paralysis, 96, 170
Paramus, N.J., 102, 111
Paris, 19
Patuxent River, 178
Peekskill, N.Y., 73-74, 98, 102
Pennsylvania, 20, 47, 64, 70, 75, 77-92, 103, 108-
11, 121, 125, 150. See also Hospital patients.
Pennsylvania Evening Post, 38
Pennsylvania Packet, 43
Pennypacker Mills, Pa., 81
Perkins, Elisha, 51
Perry, Commander Oliver Hazard, 164
Petersburg, Va., 120
Petit, Jean Louis, 16, 20
Pharmacopoeia, 89, 239
Philadelphia, 105
hospitals, 70-71, 74-76, 80, 89, 91, 109-10,
125, 127, 133
medical supply from, 30, 57, 60, 67, 69, 144,
149, 152, 188
military operations, 77-79, 80, 92, 99, 109
Philadelphia Hospital, 109-10, 127
Physicians, 1, 8-10, 15, 18-20, 37. See also Medi-
cal personnel; Surgeons.
Pike, Brig. Gen. Zebulon, 167
Pittsburgh, Pa., 134, 148, 152, 156, 162
Pittsfield, Mass., 159, 190
Plague, 115, 143, 193
Plattsburg, N.Y., 157, 159, 161, 166-67, 173-74,
190
Plattsburg Bay, battle of, 172-74
Pleurisy, 6-7, 96, 160, 194
Pluckemin, N.J., 103, 111
Pneumonia, 6-7, 159, 161, 167, 169-70, 174, 195
Potomac River, 36, 180
Potts, Jonathan, 32, 38-40, 59-60, 62-65, 70, 72,
81-85, 94-97, 109, 233
Pottsgrove, Pa., 81
Poundridge, N.Y., 112-13
President, U.S., 129, 131, 149-50
Preventive medicine, 10, 14, 160, 191-92
Princeton, N.J., 71-72, 79-81, 91-92, 99, 110
Princeton College, 72, 81
Pringle, Sir John, 3, 11, 19-20, 54, 80, 217, 218
Prisoners of war
American, 80, 113, 117, 119,
170, 180
British, 47, 94-96, 110,
180-81, 184-85, 190
Hessian, 94-95
Providence, R.I., 98, 114, 115
Purging, 1-2, 5-6, 14-15, 18
Purveyors. See Medical and hospital supply.

121, 153, 164,

119, 127, 175, 177,

297

Putnam, Maj. Gen. Israel, 51, 52, 56, 98

Quartermaster, 40, 66, 73, 83, 135, 149, 155, 175,
185

Quebec, 59

Queenston, Canada, 161

Ramsay, David, 7
Ranby, John, 16
Rand, Isaac, 56
Ravaton, Hugues, 8
Read, Willliam, 118-19
Reading, Pa., 81, 91, 109
Reamstown (Rheimstown), Pa., 81, 91
Regiments, 133, 140
1st, 180, 262
2d, 134
4th, 137
Sth, 142
7th, 142
14th, 162
17th, 163
18th, 153
28th, 177
39th, 181
54th, 163
Regulations for the Order and Discipline of the
Troops of the United States, 82
Reporting and data collection, 154, 186, 193-94,
198
Respiratory illness, 4, 6, 8, 65, 96, 136, 160, 167,
192, 194
Reynolds, James, 162
Rheims, 19
Rheumatism, 7, 96, 106, 111-12, 114, 120, 139,
152, 157, 159
Rhode Island, 56, 98, 114, 115, 150
Rhode Island College (Brown University), 115
Richmond, Va., 121, 185, 188
Rickman, William, 33, 41, 84-85, 117, 119-20,
122, 227, 228
Robinson, Col. Beverly, 97
Robinson’s House, 97, 105-6, 112, 243
Rochambeau, Comte de, 115
Roxbury, Mass., 51, 53
Rush, Benjamin, 2-3, 6-7, 17-20, 124, 144
member of Medical Committee, 23, 35-37, 72,
75-76, 719
Physician and Surgeon General in Middle De-
partment, 37-39, 72, 80-82, 98
and Shippen controversy, 39, 41-43, 69-70, 224

Sackett, J.H., 187

Sackett’s Harbor, N.Y., 152, 156, 164-68, 173-75,
177, 190

St. Clair, Maj. Gen. Arthur, 123-24, 131-34

St. Johns, Canada, 59-60
298 THE ARMY MEDICAL

St. Lawrence River, 157, 166, 174
Salisbury, N.C., 118-19
Sandusky, Ohio, 163
Sanitation, 3-4, 9-11, 50, 77, 102, 129
Saratoga, N.Y., 75, 83, 95-96
Scabies, 3-4, 6, 84, 96, 197
Scalping, by Indians, 96, 114, 134-35
Schaefterstown, Pa., 91, 109
Schenectady, N.Y., 65, 96-97
Schuyler, Maj. Gen. Philip, 32, 57, 59, 63-65, 92,
94
Schuylkill River, 79, 81
Scott, Brig. Gen. Charles, 120
Scott, Daniel, 52
Scott, John M., 133
Scott, Moses, 44
Scott, Brig. Gen. Winfield, 172, 175
Scurvy, 4, 11, 14, 63, 84, 96, 115, 142-43, 254
Secretary of the Army (1815), 187
Secretary of War, 45, 124, 126, 129, 133, 137,
139, 141-42, 144, 148, 154-55, 180-81, 186—
88, 190
Senter, Isaac, 59
Seven Years’ War, 6, 8
Shawnee Indians, 131, 137-38
Shippen, William, Jr., 54, 65, 233
acquitted in court-martial, 42-43
and Army hospitals, 34, 69-71, 80-81, 84, 88,
91-92, 97, 108, 110, 113, 120
Director General, Hospital Department, 37-39,
41-44, 105
and Hospital Department reform, 35-37, 77
medical training and teaching, 19-20, 38, 44,
114
and rivalry with Morgan and Rush, 19-20, 29,
33-35, 38, 42-43, 67, 70, 224
Skenesboro, N.Y., 94
Skippack, Pa., 81
Smallpox, 3-4, 7, 14, 62-63, 65, 92, 115, 125-27,
135, 195. See also Inoculation.
epidemics, 53-56, 59-60, 74-75, 98, 122, 191
hospitals, 56, 74, 106, 120, 123
Smallwood, Brig. Gen. William, 31, 91-92
Smith, Captain, 134
Sorel, Canada, 59
South Carolina, 115, 117-19, 150. See also Hos-
pital patients.
Southern Department (Hospital Department)
hospitals, 117-25
medical staff, 36, 45, 47, 99, 115, 117-18, 120-
21, 227
supply, 117-19, 121
Spencer, Oliver, 181, 184
Springfield, Mass., 112
Springfield, N.J., 99
Sproat, James, 109
Stamford, Conn., 72-73, 98

DEPARTMENT,

1775-1818

Steuben, Baron von, 82
Stringer, Samuel, 27, 32-35, 57, 59-60, 62-65
Sullivan, Maj. Gen. John, 27, 60, 67, 79, 106-8,
110, 114
Sunbury, Pa., 107, 110-11, 114
Superintendent of Finance, 45
Supply. See Medical and hospital supply.
Surgeon General, 161, 187
Surgeons, 14-17, 197-98. See also Hospital De-
partment; Medical Department; Medical per-
sonnel; Physicians.
British, 3-6, 8, 15, 20, 174, 196
French, 8, 15, 19, 196
Hessian, 72, 94, 96
Surgery, 1, 14-18, 96, 170, 174, 191, 196. See
also Amputations.
Surgical instruments, 7, 29-31, 46, 67, 72, 82-83,
121, 162, 188
Susquehanna River, 106-7
Swieten, Gerhard van, 4-6, 11, 16-18, 20

Tarleton, Lt. Col. Banastre, 119
Tarrytown, N.Y., 102
Tecumseh, 131, 137-38, 165
Tennessee, 150, 164, 181
Terre aux Boeufs, La., 141-43
Terre Haute, Ind., 138
Tetanus, 17-18
Thacher, James, 56, 94, 96-97, 114, 123, 126
Thames River, battle of, 165
Thomas, Maj. Gen. John, 60
Thomas, Robert, 17
Three Oaks mansion, New Orleans, 183-84
Thruston, Alfred, 142
Ticonderoga, N.Y., 59-60, 63-65, 92, 94
Tillotson, Thomas, 102
Tilton, James, 245
hospital hut design, 103, 111, 196-97, 243
Physician and Surgeon General of the Army
(1813), 152-54, 170-71, 175, 177-78, 180,
184-85, 187, 191-92, 256
as surgeon in Revolutionary War, 44, 47, 75,
80-81, 122-23, 249
Tioga, Pa., 106, 108, 110
Tippecanoe River, 138
Toledo, Ohio, 136-37
Toronto, 165, 167-68, 170
Townshend, David, 44, 125-26
Trappe, Pa., 81
Treason, 27-28, 46
Treat, Malachi, 38, 43-44, 65, 95, 111-12, 114,
123, 249
Treaty of Ghent, 181
Treaty of Paris, 48, 99, 128, 133
Trenton, N.J., 69-72, 74-75, 79-81, 87, 99, 110-
11, 125-27
Trepanning, 7, 18, 96
Index

Trumbull, Jonathan, 63, 73
Tuberculosis, 7, 159

Tucker, Thomas Tudor, 118, 121
Turner, (Doctor), 152

Turner, Philip, 38, 44, 72-73, 98, 114
Typhoid. See Fevers.

Typhus. See Fevers.

Ulcers, 125

University of Edinburgh, 2, 15, 19, 38

University of Pennsylvania Medical School, 19-
20, 137

Upshaw, William, 142

Ursuline convent, New Orleans, 183

Vaccination, 14, 191

Valley Forge, Pa., 75, 81-89, 92, 98, 102, 239

Van Ingen, Dirk, 65, 96

Van Voorhis, Isaac, 163

Venereal disease, 3-6, 8-9, 39, 96, 106, 111-12,
125, 135, 190, 195, 197

Vermont, 150, 166. See also Hospital patients.

Vincennes, Ind., 137-38

Vineyard Hospital, Va., 120

Virginia, 33, 41, 75, 84, 103, 106, 115, 119-21,
150, 178, 227. See also Hospital patients.

Wabash River, 138
War Department, 129, 135, 137, 144
War Office, 45
Ward, Maj. Gen. Artemas, 53, 74
Warren, James, 28
Warren, John, 7, 44, 48, 51, 52, 56-57, 66-67,
69, 114, 193
Warwick, Pa., 81
Washington, George, 37, 50, 85, 126. See also
Continental Army.
and Army medical organization, 22, 36, 38, 133
and Boston hospitals, 53, 56-57, 127
and general vs. regimental hospitals, 27-28,
31-32, 40-41
and Hospital Department senior staff, 28-29,
32, 34-37, 42-43, 60, 63, 69, 102, 133
and hospital reporting requirements, 40-41, 53,
77-79, 87, 105, 230
and medical personnel, 40-41, 47, 51, 67, 77-
80, 87, 92, 102
and medical supply, 30, 39, 46, 56-57, 84, 114
and Middle Department hospitals, 72-74, 81,
91, 99, 115, 125
New York area operations, 57, 67, 69, 72-73,
75-76, 77, 99, 102, 106

% U.S.

GOVERNMENT PRINTING OFFICE :

299

Washington, George—Continued
at Philadelphia, 70, 77-79, 92
and smallpox inoculation, 56, 62, 74-75, 84
at Valley Forge, 77, 83, 86-87, 92
Yorktown operations, 112, 120-21, 123, 125
Washington, D.C., 152-53, 172, 178, 180
Waterhouse, Benjamin, 153-54, 187-88, 191-93,
195
Watertown, Mass., 51
Watertown, N.Y., 167
Watkins, Tobias, 187
Wayne, Maj. Gen. Anthony, 79, 121,
131, 135-37
Weather, climate, and terrain, 154, 157, 168, 191,
193, 195
cold, 4, 10-11, 38, 84, 94, 103, 139, 159, 163,
165, 167, 170, 173-74, 192, 194
heat, 4-5, 10-11, 99, 118-19, 124, 142-43, 184,
192, 196-97
swamps and stagnant water, 3-5, 10-11, 124,
141, 177, 183, 192
West, (Doctor), 156
West Indies, 26, 28, 40
West Point, N.Y., 73, 97, 102, 105, 112-13, 126,
133, 138
Wheaton, Joseph, 185
Wheaton, Walter W., 167, 173
White Plains, N.Y., 69, 72-73, 99, 113
Whitridge, Joshua, 169
Whooping cough, 96
Wilkinson, Maj. Gen. James, 96, 140-43, 156,
164-65, 167, 169-70, 172, 181, 190, 253, 254
Williamsburg, Va., 33, 120-23, 249
Williamson, Hugh, 117-18
Williamsville, N.Y., 152, 169, 175, 188, 249
Wilmington, Del., 80, 85, 92, 125, 152
Wilson, Goodwin, 120
Winchester, Brig. Gen. James, 163-64
Winder, Brig. Gen. William H., 178, 180
Wines and spirits
medicinal purposes, 6-8, 11, 17-18, 114, 159-
60, 170, 193-94
shortage of, 41-42, 57, 83, 88, 114, 134
supply of, 64, 136-37, 139-42, 155
Wolcott, Oliver, 33
Wooster, Brig. Gen. David, 59
Wounds, 3, 15-18, 138, 175, 177, 196. See also
Amputations; Casualties.
Wyoming, Pa., 106-8.

123-24,

Yellow Springs, Pa., 48, 84, 87, 89, 92, 109
Yorktown, Va., 4, 46-48, 99, 106, 109,
120-23, 125, 127

112,

1981 - 0 - 305-138 : QL 3
02898519199